The Director of the alcohol and drug service at St Vincent's Hospital Dr Alex Wodak proposes selling cannabis in post offices to cut consumption. He made the proposal for taxed and legalised cannabis at the Mardi Grass festival in Nimbin on Sunday (!), but said he would be happy to express his opinion to the Federal Government.
I wonder what Australia has done to deserve such people. I also wonder why those doctors so concerned with the health problems of managing illicit drug use seek to employ measures that will definitely increase its use.
Cannabis use in Australia is falling as the recent National Drug Survey shows – among youth use has fallen by about 20% from 2004-2007.
This call is appallingly irresponsible. It would substantially reduce the user costs of consuming cannabis and given that the demand for cannabis certainly depends on price would encourage its use substantially Dr Wodak believes that such a move would substantially reduce consumption. How? If prices (inclusive of other costs) were less than illegal market prices then quantities demanded would be greater. If legal prices exceeded prices in illegal markets then there would be two sources of supply - illegal cheap cannabis and more expensive legal cannabis. How will this help reduce demand?
As I have written before, Wodak’s uncritical support for harm-minimisation at the expense of the most basic appreciation of the laws of supply and demand makes no sense.
Are not physicians supposed to ‘do no harm’. How is reducing the cost of a dangerous drug by decriminalising it going to help? Why pretend that current policies seeking to limit the use of cannabis are failing when they manifestly are succeeding.
Update: An updated version of this post is cross-posted at the ABC website.
Update: Here is Miranda Devine's view. Very similar to mine.
Tuesday, May 06, 2008
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15 comments:
I agree that even a basic grasp of supply and demand suggests that legalising supply seems unlikely to do much to reduce the quantity consumed, and seems likely to increase it. I was interested in Wodak's suggestion that it would be better to legalise it and gain some control over the production process rather than letting organised criminals and corrupt officials monopolise the industry.
This got me wondering whether there might be some counter-intuitive justification for the policy Wodak is proposing on the basis of gaining control of the market and using the revenues for other purposes. For example, if you had a policy legalising licensed cannabis production and you levied taxes on legal cannabis transactions, you could direct the tax revenue towards combatting the externalities associated with cannabis use. Admittedly, it seems contradictory to legalise a good with negative externalities solely to get revenue to deal with conseqeunces that occur as a result of legalisation, but then I suppose the argument hangs on whether those conseqeunces occur irrespective of legalisation, and to what degree they would be more widespread if the drug were legalised.
If such a policy were combined with a heavier crackdown and enforcement on illegal cannabis (so as to ensure the illegal cannabis was more expensive than the legal, taxed kind), such an initiative might drive people to purchase the legal kind and direct the revenues towards government to help fund information campaigns, police action against illegal drug producers, and so on.
The quasi-legal status would admittedly be cumbersome - there could also be ramifications for corruption (e.g. post office officials bribed by drug traffickers to sell their product under the guise of a legal transaction; officials get a slice of the profits to put in their pockets, perhaps?).
I think the strongest argument against it, is the decline in the number of users at present. Wodak seemed to be trying to make the point that numbers of cannabis users were soon going to overtake numbers of tobacco users, but if this is because the fall in cannabis users is smaller than than the fall in tobacco users, then the case for drastic policy action may not be all that strong.
Basically current policies are working so why change them.
You could make a case for Wodak's policy if the reduced harm costs exceeded the costs of increasing usage.
My guess is it won't. The main way that harm might fall is if extra strong psychosis inducing marijuana is displaced from the market.
But it won't be. Those wanting to purchase it will continue to do so in the illegal market.
Indeed the illegal market will become quasi-legal. How can you heavily penalise sale of a drug which is sold at post offices?
My main point is that the use of drugs is strongly on the decline among youth. The boring supply-oriented and public education programs we have been using seem to be effective. Why not continue to pursue them?
HC,
if you can show me any good research that shows cannabis is definitively worse than, say, alcohol I'll be impressed.
I had the fun of looking at a typical paper last week:
Jager, Hell et al. (2007) Effects of frequenct cannabis use on hippocampal activity during an associative memory task. European Neuropsychopharamacology, 17, 289-297.
and they find essentially no long term effect on memory with people who had on average 1900 joints in their life. Think about that next time you have nice bottle of wine and how it compares.
Given results like that, you definitely need to add all the costs involved (including opportunity costs) on policing etc. before making such statements -- especially given the health costs appear about zero and their might be some good trade-offs to be made (I'd rather see people stoned than drunk, and, in terms of remote communities, I'd definitely rather see people stoned than sniffing petrol).
In addition, if cannabis was legal, I imagine people would cook it etc. more, so you could minimize what I think are probably the main real costs (i.e., lung cancer etc.).
It is not helpful to conflate marijuana with more harmful drugs using the term 'illicit', technically the term may be correct, but only because marijuana is illegal, and it is only abitarily so when you consider that more harmful drugs such as tobacco and alcohol are not illegal.
If marijuana were to cost less to buy, there would still be the cost in time to the user. Regardless of how harmful you believe marijuana is, it is still intoxicating, and the user would be unable to make proper use of his time during the period of intoxication. So just because you can afford to be high every moment of the day doesn't mean you would want to.
By making marijuana cheaply available, you take away marijuana sales as a revenue stream for organised crime, you reduce the attraction of the drug to minors and make it less common within schools, and you separate marijuana, a relatively harmless drug, from genuinely harmful drugs like methamphetamine and heroine, so that a marijuana user would not be in contact with dealers of those stronger drugs, and be less likely to become a user of those drugs also.
Conrad, Smoking marijuana causes lung cancer and is a major reason for people seeking drug treatment. Search my blog for plenty of references. While not proven there are strong reasons for associating its use with increased risk of psychosis.
It is beyond me why people who are as intelligent as you and Wodak are, are constantly on the prowl to find reasons to legitimise use.
Why not just advocate being drug free as an ideal?
HC,
I agree with you on the lung cancer issue. However, if it was readily available, I imagine you would see a trend to vaporization, cookies etc. which are much safer. In addition, people wouldn't be forced to mix as much with tobacco, since they could essentially get as much as they wanted, and hence the total amount of carcinogens they would be exposed to would be less. I also agree with you that there is minimal evidence for some link to psychosis. However, even if this turns out to be correct, the effects is so close to zero its hardly worth worrying about vs. other things (like cancer).
However, there is a huge cost to making drugs illegal. This includes sticking people in jail, policing and so on. Given the effects of cannabis are small (almost non-extant excluding the chronic health problems of inhaling smoke), it means that if this money was meaningfully spent (potentially on more damaging drugs, like alcohol), the reduction in harm may well be greater than the costs involved in keeping it criminalized.
The second thing you need to worry about is to what extent price makes a difference. In Australia, you'll find that most heavy smokers start growing their own (exceptionally easy to do -- easier than making your own booze). This is no doubt one of the reasons that Australians smoke more than the Dutch, where its completely legal, so no matter what you make the price, its hard to see consumption declining a large amount in the long term. There's something useful to be learnt from that -- you need to consider most drugs a social problem that is not neccesarily responsive to just quick economic fixes (like pricing), especially in the long term. That's why we have high levels of binge drinking (despite lowering levels of overall alcohol consumption), ecstasy taking etc. -- its not due to price, its for cultural reasons. As an example of this, most of the reduction in smoking is surely due to a long-term health campaign, not simply price increases.
A third thing you should think about is to what extent drug taking is really amenable to traditional economic analysis. No doubt it is in part, however most drug taking is based on non-rational thought -- most people don't care about long-term consequences and the amount of drugs people take works in reverse to the consequences (i.e., people take more when they are young than old). Simply boosting the price of relatively harmless drugs leads to substitution and longer term drug production (i.e., grow your own). The easiest place to see this is in the indigenous population. I'd rather see these guys stoned out of their brains than drunk and sniffing petrol. THe latter two have terrible permanent consequences, whereas the first doesn't. Perhaps if cannabis was essentially free we would see large substitution to it.
Given these sorts of costs, it isn't clear to that you are better off, even monetarily, by not having essentially free cannabis -- and this something that people like you who think the war on drugs is good thing never provide -- and the reason for marijuana I imagine is obvious.
I might note that I don't think all drugs should be legalized -- things like ecstasy have bad permanent effects (i.e., brain damage) and people are not well informed about these (which is the governments fault -- since they advertize it as a drug which somehow kills you when you take it -- something completely dishonest). Legalization for those types of drugs therefore must be based on a different argument (i.e., people should be free to harm themselves). However, I can't see why those drugs that have essentially no or minimal long term effects shouldn't be -- sticking people in jail etc. has far worse long term consequences.
Probably most drug legalisation advocates (including myself) accept it will result in some increase in usage. However this will be more than offset than the huge reduction in the amount of harm caused by existing policies: the problem of using drugs that are often mixed with far more harmful substances, the problem that information on safe levels of usage is not readily available, the problem of having to deal with criminals in order to obtain drugs etc. etc.
Harry, do you accept that if the result of drug legalisation is "more users, but less abusers, and less crime", then it would be a good thing?
And if you doubt such an outcome is likely, how much have you read about the situation in The Netherlands and Switzerland, where marijuana usage is not treated as a criminal activity?
Its all a bit weird. I can't see the logic of the Post Office.
I'd recommend a courier service - to the door and 24/7 and only $15 (+ dope cost) anywhere in Melbourne.
NPOV, The point you make requires some cost benefit analysis of the various effects. In short I am glad you agree that legalisation will mean more use but your question is whether the extra use will involve less risk and less harm.
I don't think harm will fall much. With legal supplies the chief way that harm can be reduced is by limiting the extreme strength of cannabis which seems to be causing the rash of recent problems with dependence and psychosis.
But individuals who want the strong varieties will still be able to purchase this in illegal markets and at lower price - the existence of legally-available material should depress these illegal prices.
As I tried to emphasis - offering legal cannabis offers an additional source of supply - it by no means eliminates illegal supplies.
Penalties against cannabis use have declined dramatically in Australia particularly for users. I am not sdure that comparisons with Europe help.
HC,
you need to do some research on the harmful effects of cannabis -- I think you will find they are extremely low (essentially as low as smoking). This is why I think you are wrong on a cost-benefit analysis, and why the money would be better spent on health promotion rather than policing -- you would get better results, as happened for normal smoking. The other thing you need to think about is when the health affects happen -- things like cancer, strokes etc. happen later in life. Whilst it might not be polite to say, people dieing early saves the government money.
As as a comparison, things like ecstasy have permanent and probably irreversable effects that occur from taking smallish amounts of the drug. So, in terms of productivity loss and so on across a life-span, the cost-benefit is obviously completely different. Why not align the drugs on how much you think they cost and how much it costs the government? That way its easy to see whether the war on particular drugs is worthwhile in terms of costs. You could also guestimate how much you reduce use via campaigning versus. price rises.
Harry, where is the illegal "high-strength" tobacco black market?
If cannabis/mariajuana could be purchased in the same manner as cigarettes, there's every reason to believe the black market would quickly shrivel to an insigificant size.
In fact, this is more or less exactly what happened in the Netherlands (I did have a link for this, a very good old "Economist" article, but I'd have to search for it). Regarding increased usage, also in the Netherlands, it was almost entirely confined to 18-20yos, who eagerly took up the change to try something new. It had very little effect on overall usage rates, and note that as of 2002, only 2-3% of the population are regular uses (used in the last month), compared with over 5% in Australia and the US.
(http://www.drugwarfacts.org/thenethe.htm)
The people who have left opinions here saying they would prefer to see Aboriginal people in remote communities stoned on dope rather than petrol or grog, are either thoughtless or ignorant of the remote situations. They imagine that this is or would be an either or situation. However there are very few remote Aboriginal communities which haven't got some access to cannabis dealers. Where petrol, grog and dope are available, the pattern generally is for most people to go for the dope and grog while they can afford/obtain it, and fall back on petrol when they can't obtain dope/grog.
Of course there are some very habituated petrol sniffers who always like a cocktail of petrol along with whatever else they are consuming to get high or blotto.
As for the fantasists who think there are no links between dope and psychosis, try telling this to psychiatrists and other mental health workers who have to treat the heavy binge dopers from remote communities, or the DV workers who have to help the wives & close relatives of these (generally) men who get demented and go crazy when the supply runs out after a period of dope bingeing.
"Where petrol, grog and dope are available, the pattern generally is for most people to go for the dope and grog while they can afford/obtain it, and fall back on petrol when they can't obtain"
Try thinking about that a bit harder. If that is true its evidence we *should* be providing cannabis for (essentially) free, unless you think petrol sniffing is better than smoking dope, since petrol sniffing has aweful consequences.
"As for the fantasists who think there are no links between dope and psychosis"
The best evidence in the world, of which there is now a fair bit, shows the effect is minimal at best, so I'd be happy to tell them that (and since I know lots of these people, I will, in fact). Also, I'm not fanatical at all -- I'm completely aware of the dangers of many drugs. Your claim reminds of the anti-vaccination people who think that there are effects which there are not or where any effects is vastly swamped by the negative effects of not having it (of course, in this case, its the effects of non-legalization, like sticking people in jail and opportunity costs of spending money of policing ).
"men who get demented and go crazy when the supply runs out after a period of dope bingeing"
Again, think about this harder. This is an argument for legalization, not against.
Harry - i replied to your comment at the ALS. in no way was my post an attack on you. i apologise if that is how it read. my post was to be critical of Miranda's, Andrew's and your position on legalising cannabis not any of you personally (as i enjoy reading all three of your articles).
i urge you to think thru the issue on legalising pot - i simply cannot see how anyone could advocate banning it.
Harry,
I often disagree with you, maybe usually. You are spot on with this one. Why? (1) It's SMOKING. Harmful in itself (some studies say more so than tobacco) whatever the evidence about psycholigical effects. (2) It's SMOKING. Despite the silly argument about dying earlier, in fact, the dying takes longer and costs the public more. (3) It's SMOKING. Passive marijuana, anyone? (4) It's often mixed with tobacco. 'Nuff said. (5) If people weren't going to smoke it, as argued above, why is the use of nicotine patches and gum limited to those giving up? (6) We spend millions on trying to get people to stop damnaging themselves smoking and billions on the medical damage and this nitwit wants to promote another route?
Weird.
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