Dif­fer­ent di­rec­tion for drug users

Are Malaysians pre­pared to view drug use as a so­cial and public health prob­lem rather than a crim­i­nal one?

The Star Malaysia - Star2 - - Opinion -

GUESS how much Malaysia spends in a year to man­age pris­on­ers with a drug-re­lated crime? A fig­ure that is ap­proach­ing half a bil­lion ring­git.

And guess how many pris­on­ers are be­hind bars for a drug-re­lated of­fence? More than half of the coun­try’s 60,000 pris­on­ers.

These fig­ure emerged in an anti-drug fo­rum last month or­gan­ised by the Malay daily Utu­san Me­layu and rel­e­vant agen­cies, namely the coun­try’s anti-drug agency, the po­lice, and the Pris­ons Depart­ment.

The cost doesn’t count the wider costs of polic­ing the prob­lem, such as the po­lice raids and ar­rests, the pro­tracted court process, and the largely fu­tile at­tempts to con­trol drug sup­ply.

The worst part is that we’re jail­ing more and more peo­ple ev­ery year. We jail twice as many peo­ple now com­pared with the year 2000. Malaysia now has a rel­a­tively high in­car­cer­a­tion rate, ac­cord­ing to the World Prison Brief (pris­on­stud­ies.org).

Putting drug users in jail is costly. But more to the point, is it worth do­ing in the first place? Would it not be bet­ter for the po­lice and courts to con­cen­trate on jail­ing real crim­i­nals, like peo­ple who break into houses or snatch hand­bags?

The fact is, all the ev­i­dence in­di­cates that jail­ing drug users does not have an ef­fect on drug use.

Take a study pub­lished last month in the United States – a fit­ting ex­am­ple, since the US locks up more peo­ple per capita than any other coun­try, to the cost of US$60bil (RM258­bil) a year.

The study, from Pew Char­i­ta­ble Trusts, was in­ter­est­ing be­cause it com­pared drug in­car­cer­a­tion rates of dif­fer­ent US states (which vary widely) with drug use and ar­rests. When re­searchers crunched the data, they found no ev­i­dence these fac­tors af­fected one an­other.

“In other words, higher rates of drug im­pris­on­ment did not trans­late into lower rates of drug use,” the re­searchers noted in a let­ter to the White House, to the US Pres­i­dent’s Com­mis­sion on Com­bat­ing Drug Ad­dic­tion and the Opi­oid Cri­sis.

The let­ter also calls for more treat­ment ser­vices. Only about one in 10 Amer­i­cans in need of sub­stance use treat­ment in 2015 re­ceived it.

The United States is cur­rently in the grip of a hor­ri­fy­ing opi­oid epi­demic. Opi­oids in­clude heroin and syn­thetic drugs, such as fen­tanyl, which is 100 times more po­tent than mor­phine. The prob­lem took off af­ter a sharp rise in the use of pre­scrip­tion opi­oid painkillers in the last decade or so.

Opi­oids are now the lead­ing cause of death among Amer­i­cans un­der 50 years. The singer Prince was killed by fen­tanyl, and the drug was found in the late Michael Jack­son’s house.

Ac­cord­ing to a lead­ing health news source, STAT news (stat­news.com), opi­oids could kill close to half a mil­lion Amer­i­cans over the next decade. That’s about as many Amer­i­cans who died from HIV/AIDS in the first two decades be­fore 2000. The drug war in Amer­ica has been a dis­as­ter – a deadly one.

There is an­other way, which more and more coun­tries are adopt­ing: de­crim­i­nal­i­sa­tion. This does NOT mean le­gal­is­ing drugs – drugs re­main il­le­gal and traf­fick­ers still face the weight of the law – but sim­ply that peo­ple caught with a small amount of drugs do not end up in jail.

It’s not a rad­i­cal idea. In fact, some 25 coun­tries world­wide have al­ready adopted laws, poli­cies, or other mea­sures to de­crim­i­nalise drug use, hav­ing re­alised that it’s cheaper and more ef­fec­tive to treat rather than jail peo­ple.

At the end of last month, the United Na­tions (UN) and the World Health Or­gan­i­sa­tion is­sued a call for drugs to be de­crim­i­nalised, urg­ing “re­view­ing and re­peal­ing puni­tive laws that have been proven to have neg­a­tive health out­comes”.

This fol­lowed a sim­i­lar call by UN sec­re­tary-gen­eral An­to­nio Guter­res, in a state­ment to mark the In­ter­na­tional Day Against Drug Abuse on June 26.

Guter­res said: “I know from per­sonal ex­pe­ri­ence how an ap­proach based on preven­tion and treat­ment can yield pos­i­tive re­sults.”

In­deed he knows. When he was prime min­is­ter of Por­tu­gal, he launched the coun­try’s drug de­crim­i­nal­i­sa­tion pro­gramme. Any­one caught with a less than a 10-day sup­ply of drugs has to meet a “dis­sua­sion panel” of le­gal, so­cial, and psy­cho­log­i­cal ex­perts. Re­peat of­fend­ers may be pre­scribed treat­ment such as methadone, which re­lieves with­drawal symp­toms.

The pro­gramme got the heroin epi­demic un­der con­trol and led to a dra­matic drop in HIV in­fec­tions and drug fa­tal­i­ties (now one of the low­est in Europe). And, con­trary to naysay­ers, drug use among the young also dropped. To­day, the pro­gramme is con­sid­ered a model.

We al­ready have some drug treat­ment pro­grammes with im­pres­sive re­sults, such as the vol­un­tary Cure and Care Clin­ics. So why don’t we in­vest more in what works? Just imag­ine if we spent that half a bil­lion on treat­ment rather than keep­ing peo­ple in jail.

That, though, would re­quire a sharp shift in the way we view drugs. Are Malaysians pre­pared to view drug use as a so­cial and public health prob­lem rather than a crim­i­nal one? That may be for you, the public, to an­swer.

Man­gai Balasegaram writes mostly on health, but also delves into any­thing on be­ing hu­man. She has worked with in­ter­na­tional public health bod­ies and has a Mas­ters in public health.

Would it not be bet­ter for the po­lice and courts to con­cen­trate on jail­ing real crim­i­nals?

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