Healthy debate needed on War on Drugs

Sometime around 1979 the family that ran the drugs business in Dublin had a ‘drought’ of the product that was beginning to take off in terms of sales

That product – cannabis – was selling well, but a new drug, heroin, had an even bigger profit margin. And so, to launch heroin, there was a planned ‘drought’ of cannabis to encourage users to take up the new product. And many, of course, did. We have had a drug problem since then – mainly confined to the inner cities (and particularly Dublin) and have been able to do very little about it.

Everyone has their opinions on the drugs business – and to clarify, we are talking here about the illegal drugs business – and they are sometimes widely divergent. The one thing everyone accepts is that we have a drug problem – in terms of large numbers of people using drugs recreationally, and a large number of people who are addicted to drugs such as heroin and cocaine.

A Citizens’ Assembly will take place next month to discuss the issue and to coincide with that, Irish Medical Times will run a special issue on cannabis; to attempt to examine the prevalence of cannabis in society, and to ask whether or not it would be a good idea to make cannabis legal – as has been done in several other countries.

There are many issues involved in the legalisation of cannabis – the first one being whether one is talking about actual ‘legalisation’ or ‘decriminalisation’, which are different animals.

Even within that framework, some anti-legalisation people would suggest that decriminalisation leads on to legalisation, so it’s pointless to separate them.

Whatever the terminology or nomenclature, the pressure on the Irish government to legalise cannabis comes from legalisation elsewhere. Irish governments are not known for being first with new concepts (the workplace smoking ban being one major exception to that rule) but as more States across the world legalise cannabis, the calls for legalisation here become louder.

Then there’s the whole issue of medical cannabis. Should patients be allowed to access the drug if they find it eases their pain or lessens their symptoms? And do they need a doctor to approve their use of the drug? What of the patient that is using cannabis as medication that moves to Ireland?

Whatever the answers to these questions, it is clear that we need to have a national conversation about drugs, their uses as medications and recreationally, and what we are going to do to regulate their use. Hopefully, Irish Medical Times will make a positive contribution to that debate by airing the range of views out there in Irish medicine, and facilitating a medical angle to this debate, which is crucial.

Many of these things are unknown. We don’t really know what the future brings and how our actions could impact on future generations. It’s too early to tell what the effect of the French Revolution will be, Mao averred, and equally we just don’t know what effects legalisation or decriminalisation would have.

We can look at other countries and examine what happened in other jurisdictions, but we are different from, say, Colorado or Columbia, and though one can perhaps expect some correlation between some countries that have legalised cannabis, there are also some wide disparities.

One thing we do know for sure – we have a large drug problem in this country, and we can’t just ignore it and hope it will go away. The pandemic, if anything, seems to have increased problematic alcohol use, and with the decline in rural pubs and more people drinking at home, the nature of the consumption of alcohol has also changed.

All these things are connected from a health and medical perspective. Today we will see the traditional Irish tolerance for alcohol consumption, for example. People travel to Ireland because of our reputation for ‘having the craic’ or, more accurately, our willingness to ignore drunkenness and to tolerate it to a certain degree.

How would the decriminalisation of cannabis affect alcohol consumption? Would people switch or would they merely add one more drug to the mix?

All these questions are complex and involve a certain amount of speculation. In the past, compassion has been a driver of changes in the law – such as the reform of the divorce, abortion or same-sex statutes – and hopefully compassion would be the driver this time around too.

And it’s vitally important that all sides of the debate are heard. We hope to contribute to that debate and provide a forum in the April edition of Irish Medical Times for all views to be heard.

The international evidence suggests that the War on Drugs has failed. It is impossible to stop drugs entering a country when there is high demand and profit to be made. A different approach is long overdue and perhaps we are now at the start of this change in Ireland.

We look forward to a healthy debate and have a Happy St Patrick’s Day – whatever your tipple!

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