Saturday, May 17, 2008

Drug treatment industry supporters of illicit drug decriminalisation

I've posted before on the preposterious claims of Dr Alex Wodak that decriminalising cannabis use would decrease use. To the extent it provides an additional source of supply not subject to the user costs of relying on illegal markets I find it impossible to believe such claims*. The difficulty with these effoneous claims is that current policies to reduce cannabis use are working effectively. This is a beneficially especially because cannabis use itself is, in fact, increasingly seen as a dangerous illicit drug rather than something benign.

Miranda Devine asks what should be done about Dr Wodak's position as Director of the alcohol and drug services at St Vincents Hospital? I have not heard criticism of his work in this role so I guess not much. But he does speak with a voice of authority. I think he inflicts a lot of false views and hence social damage on the community because of these views but I assume we have to live with that cost as one of the effects of living in a democracy.

Moreover, my experience with the APSAD meetings is that many in the drug treatment industry (those earning good livings from treating those with drug and alcohol problems) are supporters of liberalising policies with respect to illicit drugs. Dr Wodak is not alone. Most of these people have never made any attempt to study economics or other disciplines that address the social effects of eliminating constraints on drug usage and instead look solely at the welfare of patients as they present themselves for treatment right at the time of treatment.

It is a deep problem that many of these supporters of legalising illicit drugs depend for their existence on the public teat. I wonder how many tax payers are aware of this?

(*) A logically consistent claim would be to assert usage might decline with legalisation because people demand cannabis because it is illegal for 'thrill-seeking' reasons. This seems to me farfetched. The legalisation of alcohol after prohibition in the US did not discourage use.

26 comments:

Anonymous said...

But imagine queueing at a post office for a spliff! You'd rather quit!

Jacques Chester said...

Harry;

I feel you may be misrepresenting or misunderstanding the fellow's case.

He's trying to propose a least-harm model and takes the view that heavily regulated legalisation is the way through. The Auspost comment seems to be a joke in poor taste at the expense of Australia Post more than anything.

He backs up his assertion that legalisation would reduce usage by comparing Amsterdam with San Francisco, though off the top of my head I can think of confounding factors, such as SF being the worldwide capital of hippiedom.

At its core it seems like he is making the standard anti-prohibition argument that illegal drugs still get sold, but without any regulation whatsoever. Potency and safety are completely uncontrollable. Prohibition further rewards criminals with massive, untaxed profits, some of which is channeled into corrupting the police force, undermining the utility of that institution.

hc said...

Jacques,

I think the postoffice reference is a joke but his policy prescriptioon is not. That is his long held position.


He claims 39% of San Francisco residents had smoked cannabis more than 25 times, compared with 12% of Amsterdam residents.

To quote Devine:

'Unfortunately for Wodak, Dr Don Weatherburn, the director of the NSW Bureau of Crime Statistics and Research, and Wayne Hall, Professor of Public Health Policy, University of Queensland, had his number, so to speak. They also wrote a letter to the editor, pointing out the flaws in his research, which compared apples with oranges.

"The San Francisco sample was older, less likely to have children and more likely to have been unemployed in the preceding two years. These factors may be the reason for the higher level of consumption in San Francisco," they wrote.

Their coup de "grass", if you pardon the pun, was NSW research showing "most regular cannabis users say they would use it more often if it was legal. Consumption increased substantially in the Netherlands after the creation of a de facto legal market."

Even the strongest supporter of legalisation suggests the single adverse effect may be to increase demand. I would strengthen 'may be' to 'will almost certainly'.

How will the dangers of cannabis be reduced by providing it legally?

By stopping the smoking of it leading to the holes in lungs recorded in young smokers? How?

By reducing potency? Almost certainly not because the illegal market will still exist.

I see no upside at all.

The argument that illegal cannabis markets create the potential for police corruption requires data on numbers and effects. The best argument against it is that current laws seem to be working well.

Spiros said...

"depend for their existence on the public teat"

Well, Harry, if it comes to that, so do you.

(As do quite a number of blogosphere advocates of "small government".)

hc said...

Spiros,

I don't urge university students to take harmful drugs.

I don't have a great 'small government' focus. I favour expanded involvement in providing environmental services and support public health and public education when there is sufficient private competition.

Jacques Chester said...

"How will the dangers of cannabis be reduced by providing it legally?

By stopping the smoking of it leading to the holes in lungs recorded in young smokers? How?"

I think I've said here before that you could smoke tea leaves or grated carrots and get cancer. That's a property of inhaling smoke from organic matter burnt at low temperatures. It's not a property peculiar to marijuana.

To avoid lung damage, users would have to switch to using resin instead.

"By reducing potency? Almost certainly not because the illegal market will still exist."

Actually I'd imagine that increasing potency would reduce overall smoke inhalation, by way of analogy with the way low-nicotine cigarettes cause people to smoke more.

I don't know if legalisation would increase or decrease usage. You say that it increased in Amsterdam, but again there are confounding factors: foreigners traveling there for a licit puff or hash brownie, for example.

Anonymous said...

HC,

you still are not taking into account trade-offs between other factors, like the cost of sticking people in jail and so on. If we have a bit more cancer and much less jail time in the short term, what's the trade-off here? Similarly, if we have a few billion dollars to spend because of the much less jail time, are you really saying that a health campaign couldn't get usage down in the long term (as, for example has been the case with cigarette smoking) ? It seems to me that your default position is "no" on this, with no evidence. Can you provide some long term model of this -- surely you have this sort of data hanging around?


In a simialr respect, just because usage is decreasing doesn't mean that is due to more successful policing (how have the police been more successful -- they haven't with marijuana -- it's still essentially in limitless supply, and as we know, all "addicts", even in the psychological sense, find ways of getting some with little care for the cost).

conrad said...

Sorry, that was me.

conrad

hc said...

JC,

The 'holes in lungs' issue is cited in the British Council report. Young heavy cannabis smokers.


I think inhaling burnt organic matter can't ever do your lungs much good. I guess the point about addictive activities like cigarette smoking and smoking cannabis is that you repeat these activities. Hence greater harm.

I agree with the second part of your claim Conrad. I think young people increasingly see cannabis users as losers rather than hip. To some extent it is going pout of fashion.

Costs of policing and the courts are long-term measures to reduce usage. There are stock as well as flow benefits.

conrad said...

Still no function? You're argument would be much stronger if you could give the function and that way people could simply argue over the parameters (e.g., demand by price, cost of harm reduction etc.) -- at the moment there is still no model. For all I know, such a model might well be a strong argument for your case, and I can't see why it would be hard to create (just get the main factors, limit the initial total amount such that we don't worry about opportunity costs, and see how they behave with different assumptions over time -- surely this is standard economics).

i.e., if you have a fixed amount to spend on policing and harm reduction, what is the effect of this in the long term?

Francis Xavier Holden said...

"Most of these people have never made any attempt to study economics or other disciplines.."

And exactly how many economists have sucessfully been involved in the welfare and treatment of drug abusers?

hc said...

FXH,

Probably none though there is some work evaluating the economics of different approaches.

Of course I am not talking about treatment options but social policies. How one can advocate introducing legal markets without some knowledge of ecobnomicsd is beyond me.

Spiros said...

Of course the real scandal in all of this is Devine trying to get Wodak sacked because of his opinions on drug liberalisation, which have SFA to do with his work in treating addicts.

This would be like a newspaper columnist trying to get Harry sacked from his job as economics professor, because of what he writes in this blog.

derrida derider said...

What spiros said - I've always considered the Devine Miss M a bit of a lowlife, and this is just another example.

many in the drug treatment industry ... are supporters of liberalising policies

Yes indeed, Harry, but have you considered this might be because they see the effects in their industry of illiberal policies?

Anonymous said...

What variables most significantly contribute to cost-benefit analyses that favour the continued legality of the sale and consumption of alcohol and tobacco?

hc said...

Disappointing comments. Derrida's comments that physicians see the harm caused by drugs and harm caused by prohibitive regimes is true. But that is not a basis for determining social policies. Then you have to consider the effects of prohibitive regimes on incentives to use as well as the welfare of those using.

It is interesting that the thrust of comments that legalisation is the way to go is not supported by the major political parties and is overwhelmingly rejected by the community. My own position is much closer to the social consensus.

conrad said...

"the major political parties and is overwhelmingly rejected by the community. My own position is much closer to the social consensus."

If you can't provide the real data for the simplest of arguments (which should be simple if you work on it seriously), go for popularity (possibly not even that for pot) even if there are examples of those policies which failed in the 20th century (alcohol, cigarettes). Come up with your own opinion, you're not a sheep, and I can't see why you are not aware of the real arguments behind it (including the economic ones which you should be fully aware of). Or is it that you think the economic support liberalization (as the decriminilization people did?

hc said...

Conrad,

I did not claim the majority were right just that popular views differ from those expressed. Can you honestly say after reading my blog that I simply adopt consensus views?

It isn't easy to get data on these issues. Markets are illegal and concern is with counterfactuals - what would happen were cannabis legal? One large cost is that of imprisonment - but I have never advocated imprisonment of cannabis users - I doubt it occurs much these days anyway.


Provioded legal costs related to prosecuting cannabis use don't become huge and cannabis use is declining I can live with the current system.

conrad said...

"It isn't easy to get data on these issues"

Why don't just use a parameterized model? That way you can see the range of parameters that support your argument. They may quite inclusive for all I know. But until you specify the actual factors you think are important, its almost impossible to know how cost trade-offs work. Most of the pro-legalization studies, for example, don't take into account loss of work-place productivity and so on (I'd be happy to include them).

i.e,. you would have two equations like this

Cost(t) = f(nusers, nasty_stuff) - f(nusers, enforcement)

nusers(t) = f(nusers(t-1), social policy, economic policy, etc.).

So what I want to know is what you consider the cost of nasty stuff is and how social and economic policy change the number of users. You could just use a distribution to model amount smoked per user and then modify that with a second distribution to model nasty_stuff. You should then end up with a number.

As for what happens over time, you simply choose parameters similar to that of other public health campaigns (seatbelts, cigarettes etc.), and that way you could see whether the cost of spending the money in the long term on social campagaining trades off enough with other factors (e.g., street price).

Francis Xavier Holden said...

harry - to a large extent I actually agree with you that a lot of policy is too driven by clinical experience.

But equally, or perhaps worse, most economics writing is done from a desk with the writer having no idea at all what goes on on the ground.

Clinicians work from a biased and small sample in a lot of issues - drug use being one. People who use drugs without any significant problems do not show up at treatment clinics. To a large extent they don't show up on economists spreadsheets and data bases.

Most of the drug data comes from a law enforcement / illness perspective and even that which doesn't is biased by the illegality of much of the use.

Clinicians are very influenced by recent cases seen or experienced and spokespeople will often extrapolate to entire populations from sample sizes of 10 ("surge in overdoses").

Wodak has a good track record in my book and I would let him have a few crazy ideas (selling dope in POs) in order to utilise his experience. My guess is dope smoking would go down if de-criminalised as people would shift to ingesting in other ways. Dope consumption might not chaneg much.

Anonymous said...

Harry, you quote Devine "Consumption increased substantially in the Netherlands after the creation of a de facto legal market.""

And has decreased in the years since. There was an initial surge and then usage dropped back and has continued to decline.

I used to live in Amsterdam, and the locals don't use much cannibis. The coffee shops (ie. where you can buy the stuff) are pretty much strictly for tourists. Amsterdammers are into drinking not smoking (you can't get alcohol in coffee shops)


Jacques " such as SF being the worldwide capital of hippiedom"

And Amsterdam isn't? It's much more liberal than SF, and preserves much more of the 60's hippie culture.

Yobbo said...

How would legalising marijuana reduce harm?

Pretty simple, you would have more people eating it and less smoking it.

Eating it is a great way to take it but much more expensive than smoking it.

Legal marijuana would be extremely cheap.

Yobbo said...

Of course, the most harm reduction would be stopping the war on drugs entirely.

The vast majority of harm caused by drugs is caused by the laws and enforcement associated with them, and comparitively little by illicit drugs themselves.

Many more people end up in jail because of Marijuana than develop schizophrenia because of it, for example.

pawan said...

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Anonymous said...

At its core it seems like he is making the standard anti-prohibition argument that illegal drugs still get sold, but without any regulation whatsoever. Potency and safety are completely uncontrollable. Prohibition further rewards criminals with massive, untaxed profits, some of which is channeled into corrupting the police force, undermining the utility of that institution.apart from drugs smoking also causing people's health.

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Victor2008 said...

He's trying to propose a least-harm model and takes the view that heavily regulated legalisation is the way through. The Auspost comment seems to be a joke in poor taste at the expense of Australia Post more than anything.
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Victor
Drug Rehabs