WHY NZ IS LEGALISING PARTY DRUGS
I’ve tried probably 150 different psychoactive chemicals,” the man with the Israeli accent tells me over the phone. “So to me simply as Dr Z, the man is a mathematician who used to design sleeping pills for a major pharmaceutical company. The drugs he designs these days are more likely to keep you awake. His most famous creation is mephedrone, or “meow famous legal high.
Drugs like mephedrone usually slip onto the market via shadowy underground networks. Dr Z willing human guinea pigs from the online “psychonaut” community. But this clandestine system may soon be a thing of the past. Dr Z is now testing a number of drugs in rigorous pharmaceutical labs and costing hundreds of thousands of dollars.
The trials are the result of a radical shake-up in drug policy in New Zealand. Last July, its government passed a law that will allow new recreational drugs to be sold openly as long as they meet certain safety standards. Before long, Dr Z hopes his drugs will be on sale there, alongside alcohol and tobacco – taxed, regulated and entirely legal. This doesn’t mean NZ is legalising all drugs; far from it. Existing illegal drugs won’t change their status. Nevertheless, the law is a decisive break with prohibition, a policy that has had a stranglehold on international drug enforcement for more than 50 years.
Other countries, too, are breaking ranks on prohibition, leading some to claim that the entire experiment could provide some answers to the long-running and bitter arguments about whether banning drugs prevents or causes terrible harm.
If prohibition’s aim is to prevent people from taking drugs, it isn’t very successful. In 2011, an estimated 300 million people worldwide took illegal drugs, up 18 per cent on 2008. Even the world’s top drug enforcers struggle to put a positive spin on this number. “We have to admit that, globally, the demand for drugs has not been substantially reduced,” wrote Yury Fedotov, executive director Crime, in last year’s World Drug Report.
to some estimates, the United States has spent $1 trillion on domestic drug law enforcement over the past 40 years, only to see a rise in drug use. Since 2006, 50,000 people have died in Mexico’s drug wars. To some, these failures simply demonstrate that prohibition hasn’t been pursued vigorously enough.
it or not, the demand for drugs cannot be stamped out, and there will always be people willing to supply them. Where drugs are illegal, the suppliers highly suspect. It is surely better, say the reformers, to set up a system that divorces drugs from criminality and allows controlled access to compounds that are known to be relatively harmless. NZ’s radical new law will be the closest thing yet to a test of that claim.
That’s not to say the country is deliberately Its motive is largely pragmatic. Possibly because NZ has a longstanding problem with new psychoactive substances – commonly called to take off there was BZP (benzylpiperazine) in the late 1990s. It was marketed as a safe and legal alternative to amphetamines, and by 2008 more than 5 per cent of adults reported taking it in the previous year – more than twice as many as had used illegal amphetamines.
The NZ Government initially turned a blind eye, but banned BZP in 2008 after reports of serious was eventually banned, only to be replaced by is now routine: a new drug appears; it is sold legally until the authorities spot it and ban it; then another drug takes its place and the cycle starts over again.
The game of cat-and-mouse is spiralling out of control. In 2009, European authorities reported 24 new synthetic drugs. In 2010 there were 41; elsewhere around the world. These drugs cater to all sorts of tastes. Many are synthetic versions of cannabis. Others are amphetamine-like stimulants, ecstasy substitutes or hallucinogens. Some are pharmaceuticals that never made the grade.
tried to break the cycle by introducing “emergency scheduling”, which means new drugs can be temporarily banned without recourse to the normal parliamentary rigmarole. Others, – any chemical that is structurally similar to an existing illegal drug.
New Zealand tried both those approaches with little success, says James Dunne, a drug-law has worked for legal high manufacturers. Emergency scheduling just accelerates the cat-and-mouse game, he says. The result is the sale of drugs that have barely been tested. “It sends the wrong incentives to manufacturers – develop something that’s hard to identify and sell as much of it as you can as fast as you can.”
to chemists”, says Dunne.
“When you say that these chemicals are structurally similar, you’re also saying others aren’t – and [thus] pointing the way for future drugs.”
PROHIBITION WAS HARD ENOUGH IN A WORLD where governments knew what drugs to ban. Now, in a world where new drugs appear every week, it seems altogether impossible.
While the rest of the world is cranking up the treadmill, NZ has decided to get off. Last year, the Psychoactive Substances Bill passed both houses of parliament with only a single dissenting voice.
Reading the bill to parliament, associate health minister Peter Dunne explained that prohibition simply couldn’t keep up with the turnover of new drugs. “Scores of products with unknown effects this regulatory void,” Dunne said. “This proliferation of poorly understood chemicals and their widespread use should concern us all. So we need an enduring solution.”
The details of his proposed solution are still a little hazy, though some basic rules have been set. The most important is that drugs won’t be allowed on the market unless they have a proven means and how it will be decided are a work in progress. Drugs also won’t be sold to under-18s, at convenience stores, or anywhere alcohol is also on sale. Labels with ingredients and health warnings will be mandatory. Existing illegal drugs won’t be legalised, but Dunne says this could be done later.
A new authority charged with implementing the regime is still working out the other details. The law is expected to come into full effect as soon as the end of this year, once safety tests are completed. Meantime, NZ is in a halfway house. When the law was enacted last July, legal highs that had been on sale for at least three months could apply for temporary licences; 46 were approved and six refused, based on an assessment of risk. Retailers also had to apply for licences to continue selling those drugs. From an estimated 3000 outlets, the authority granted 110 licences.
Until the new regime goes “live”, there are many unanswered questions about how it will operate. The biggest is how to decide which drugs are suitable for sale. Exactly what constitutes “low risk”? For the past 15 years, David Nutt, a neuropsychopharmacologist at Imperial College London, has been trying to answer that question. His approach takes into account harm to individuals, the risk of addiction, and social damage. “You come to a sensible balance,” says Nutt. “You look at the bigger picture.” By this reckoning, the most harmful drug is alcohol, followed by heroin and crack cocaine, according to medical journal The Lancet.
harms is only half the problem. The next step is deciding where to draw the line. Nutt liaised with the NZ regulators on this question. “I told them they should set the threshold as less harmful than alcohol, but they laughed and said that’s too harmful,” Nutt says. He now suggests “half as harmful as alcohol” would make sense.
Wherever the line is set, the next challenge is how to prove a drug is on the right side of it. Dr Stewart Jessamine, head of Medsafe, NZ’s version of the US Food and Drug Administration, says the initial requirement will be similar to the “phase 1” safety data pharmaceutical companies must provide before they can do large-scale clinical trials. After that, the key to safety will be surveillance. If a drug starts to cause more harm than expected, Medsafe will be able to further restrict its sale or ban it completely. An interim version of this system has already been introduced. Any negative effect reported to a hospital or poisons hotline is ranked in one of three categories. Mild reactions, such as restlessness, mild pain or vomiting, are given a score of 1. Cramp, unconsciousness or hallucinations score 2; coma, paralysis or deafness score 3. Any product that accumulates a score of more than 2 per 20,000 units sold is taken off the market.
In this way, Jessamine says the risks can be studied, controlled and communicated to users, and laws adjusted accordingly. There will be no need for manufacturers to constantly dream up new drugs. Consumers who want to stay on the right side of the law won’t be forced to give up a legal high they know works for them and try a new, possibly more dangerous one. NOT EVERYBODY SEES THIS APPROACH AS a panacea. Forensic toxicologist Dr Keith Bedford, under NZ’s old system, points out that it fails to take into account people’s tendency to mix drugs with alcohol or other recreational substances.
That’s something the country has seen before. Many of the people who had serious reactions several drugs, says Bedford. He works for ESR, the company that does all of the NZ Government’s forensic toxicology work, and has seen a lot of the toxicology data.
Published studies back up Bedford’s claim. A 2010 study by Dr Chris Wilkins, head of the illegal drug research team at Massey University in Auckland, found that 86 per cent of BZP users alcohol, but also cannabis and ecstasy. “I think, unfortunately, they’ll get some nasty surprises that their low-risk product is used in combinations,” Wilkins says. “That’s something that’s hard to model in advance.”
Similar adverse drug reactions have been spotted elsewhere. In 2012, for example, the European Monitoring Centre for Drugs and Addiction reported that 21 people had died after taking an amphetamine called 4-MA. But if you look at the reports, in each case 4-MA was combined with other drugs. Bedford suggests the safety testing ought to include combinations, at least with alcohol. But according to Jessamine, that’s not likely to happen: “It’s much more likely that they’ll be required to include advice about not engaging in those behaviours on the packet.”
Dr Z supports the new law, but he also worries about people mixing drugs. On behalf of a group of legal high manufacturers, he is coordinating studies of an MDMA analogue called 5-MAPB. “It’s a good drug, it’s fun,” he says. “So people will start drinking on it.” But he warns that the structure of the chemical suggests that mixing it with alcohol would be very risky. “People could happens? The newspapers will react. The whole ‘dangerous’ and it will never be heard of again.”
As these issues are dealt with, international experts are watching, some hoping the results will demonstrate that an alternative to prohibition can work. “This comes at a time when drug prohibition is collapsing,” says Dr Alex Wodak, recently retired director of the Alcohol and Drug Service at St Vincent’s Hospital in Sydney, and former head of the International Harm Reduction Association. “The long debate is now over and the political phase has started. More and more people are realising that drug prohibition is getting harder and harder to defend, and the taboo has been broken on discussing alternatives.” Wodak says the outcome is a groundswell in countries looking for alternatives.
fully legalise cannabis. Pharmacies are allowed to
HERE IS A POSSIBILITY OF A BIG PUBLIC HEALTH GAIN … OR A REALLY BIG PUBLIC HEALTH DISASTER. –Dr Chris Wilkins, Massey University
sell 40 grams a month to individuals, people can grow up to six plants themselves, and “cannabis clubs” can grow up to 99. Other Latin American countries are dissenting too. In 2011, Bolivia withdrew from the 1961 Single Convention on Narcotic Drugs and rejoined last year with the raw source of cocaine. The presidents of Guatemala and Colombia are both calling for prohibition to end.
In 2012, a summit of the Organization of American States – an international organisation of 35 countries from across the Americas and the Caribbean, including the US – resisted US pressure to duck the issue, and discussed alternatives to the war on drugs. Last year it released an options paper that included legalisation as one possible way to go. Within the US itself, two states – Colorado and Washington – have legalised cannabis. Britain’s Deputy Prime Minister, Nick Clegg, has also come out in support of a debate about prohibition.
These efforts are likely to snowball, says Wodak. After cannabis was legalised in Colorado and Washington, public support for cannabis legalisation all over the US jumped to 58 per cent, favour. “Other US states will follow,” Wodak says. “All this is coming about because it is now inescapable that global drug prohibition has been ineffective, counterproductive and very expensive.” But it won’t happen overnight, he predicts. “Global drug prohibition took about 80 years to construct, so I would not be surprised if the post-prohibition policy also takes a while to build.”
Wodak foresees the NZ approach will have obvious contradictions, with relatively unknown synthetic cannabis being legal while natural cannabis is still banned, despite being well-studied. But synthetic drugs are a good place to start since banning them is particularly problematic, he says.
NZ’s laws may be giving the world a glimpse of what a post-prohibition era will look like. “It’s just reduce the harm caused by prohibition,” Wodak says. “It’s a good example of the start of evidence-based policy,” adds Nutt.
In 2016, the UN will hold a special assembly to review its approach to drug control. Nutt is hoping international momentum against prohibition will lead to a change of heart, and he’s pushing NZ to lead the meeting. The US will undoubtedly exert pressure to maintain a hard James Dunne. “There would have to be some fancy footwork to explain how Colorado and Washington legalising the sale of marijuana is okay but Uruguay doing it is not.” He notes the Kiwi approach attracted a lot of interest at meeting. And together with South America, and to a lesser extent Europe, there will be
Ultimately, whether the rest of the world follows NZ’s lead depends on the results of its experiment. And saying no to prohibition, even in a limited way, might not be risk-free. Evidence suggests prohibition has sometimes reduced drug use in NZ. When Massey University’s Chris Wilkins studied legal highs in NZ in 2006 while BZP was still legal, he found 15 per cent of people had tried a legal high in the previous year. By 2009 – a year after it was banned – he found that
The reasons aren’t clear. Wilkins says it might highs hadn’t yet gained popularity. But there was an indication that prohibition was also turning users off: 30 per cent of people who stopped using BZP gave the ban as a reason. That raises the question of whether making drugs legal would encourage people who would otherwise abstain, or prompt current users to take more. If the BZP study is indicative of what might happen, NZ could be in trouble, says Wilkins. “If the prevalence of legal high use tripled, you might end up with more total problems even if the product was low harm,” he points out.
Whether that will happen isn’t clear. When the Netherlands liberalised control of cannabis in the 1970s, there was no major rise in cannabis use. When Portugal decriminalised personal use of all drugs, drug use stayed about level, but the
And looking around the world, there seems to be no direct correlation between stricter drug laws and decreased consumption, at least according to a 2008 World Health Organization study. Some researchers say NZ’s law is already having positive effects. “Since the bill was enacted we’ve seen fewer hospital admissions and emergency presentations associated with the use of synthetics,” says Dr Paul Glue, head of psychological medicine at Dunedin School of Medicine.
Wilkins says the NZ experiment will “stand or fall” depending on whether people replace bad drugs – cocaine, heroin, and maybe even alcohol – with the safer ones, or simply take more drugs. There is some evidence that legalising marijuana in the US correlates with a reduction in heavy drinking among 18- to 29-year-olds. Whether Kiwis will swap booze for pills is still a huge unknown.
Wilkins has applied for funding to study this crucial question and has set up an international research group so the world can learn from his country’s bold experiment. “Here is a possibility of a big public health gain on the one hand, or a really big public health disaster on the other,” he says. “But there will be no-one more excited than
High hopes …( above left) Uruguayans who marched in favour of legalising marijuana won success last year; (above) a pocketful of designer dreams may soon be reality in NZ.