02 - The harm
Much like Professor Nutt I am going to break harms out into harms against the user themselves - and harms against society - the people around the drug user, sometimes who have never consented or wanted to have a drug user near them.
But first, I am going to address the biggest problem head on. This should really be in the whataboutisms section, but it's a big one and needs tackling head-on if you do not understand what harm reduction is about. OK, here goes.
Are drugs safe?
No!
Can you ever make drugs 100% safe?
No!
So what can we do with the tools in the harm reduction toolkit? We can look at the risks and take as many steps as possible to reduce the risk. No human activity is risk-free. In 2022 - still a pandemic year - there were 1,695 deaths on the roads in the UK. That's roughly 4.6 deaths a day. There were 22,454 deaths from the virus itself, about 61.5 per day. Given the rate that society is pushing to 'get back to the office' and to 'get back to normal', we have a pretty fucked up sense of what the real dangers are.
That out of the way, if you are not familiar with Professor Nutt's work then I recommend you read this paper before continuing;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/fulltext (free, registration required)
Yes, that is the Professor Nutt who was removed from the ACMD by the piece of dangling knob-cheese Tony Blair, for saying that more people die from riding horses than taking MDMA in the UK each year. While he is not wrong, I think he was slightly unwise to phrase it like that. Since drugs are illegal we can never know the true number of users so a direct comparison of the raw numbers is a bit unscientific. The ratio of uses to deaths per year is a better statistic to use but we will never know what that number is while drugs are illegal. Please do note though that the paper is peer-reviewed and published in The Lancet. If I ever had to place my life on the line and choose between advice from Professor Nutt or a crazed warmonger, I'll take the good professor's advice every time.
And I'm not going to labour the point about the differences in harm ... fuck it, yes I am. It's alcohol. The problem is booze. The one drug that is legal is also the one that causes the most harm to the user and to society. Well done governments of the world, you've banned the safer ones and kept the most dangerous one legal. You should be proud of what you've done. Go and give yourselves the clap you bunch of spineless cretins.
Harms to the user
Medical harms
Strangely enough, this is the category that we know the most about as a species, and know enough to mitigate. We know that smoking causes cancers in the lungs, throat and mouth. We know that unregulated heavy drinking leads to diabetes and renal failure. We know that people with heart complications probably shouldn't be taking stimulants and MDMA and then doing high-energy activities like dancing for 8 hours.
The only problem is that right now, we know these things and don't do anything about it. We screen for things like breast cancer and prostate cancer regularly once we hit a certain age. We are told that a persistent cough is one of the signs of lung cancer. Every smoker has a persistent cough. All the time. But they pass it off as 'smokers cough' and only visit the doctor when it is late in the day. The earlier we catch these things medically, the cheaper and easier it is to both treat the disease but also offer interventions to bring the user away from the harms they are doing to themselves.
The unknown strength and provenance also goes here. We've all heard the stories from the police about 'cocaine cut with glass powder' and that's frankly bullshit to scare the children as powdered glucose is far easier to obtain than glass powder, whatever that is. But without regulation there really could be anything in that substance you are being sold. Think back to the days before alcohol regulation, or prohibition era US, where the alcohol could literally - and frequently did - outright kill people.
The police in the UK already try to do harm reduction - they will make public announcements when there is a 'bad batch' of heroin going around (really, this usually means it's stronger than people are used to so they OD easier, rather than being contaminated) and prison officers will warn their addicts that the heroin on the outside is way stronger than they are used to on the inside. If we are committed to saving lives in this way through harm reduction then it would make the most sense to actually regulate content and strength, so people know what they are getting each time. We already do this with alcohol.
Legal/economic harm
I have put these two together as to the user they are fairly closely related. During the fairly recent legalisation of cannabis moves in the US, one outlier was a group of mothers. They had children who were about to become teenagers and they were campaigning for legalisation. Their point was that across all of them, as a group, at least some of their children were practically guaranteed to try cannabis at some point. They argued that the most dangerous thing about cannabis was being caught with it. An arrest, a conviction, maybe some jail time, that sort of thing can change the course of a young life.
For me as well, if the truce hadn't been on then being caught a couple of times with simply personal amounts of club drugs could lead a bad-tempered judge to lean towards prison. Again, time in prison is a near certainly lost job, probably a broken lease or mortgage on your home and a couple of months later you are kicked out of prison with no job, no home, £90 in your hand and poor prospects of getting another decent job in your field as a convict. At that point it probably makes more sense economically to fall in with the friends you made inside and start doing crime. Congratulations government, you are manufacturing criminals while asking the taxpayer to cover the cost of making them.
The last part for this section is the perverse incentive of criminal drug dealers to either upsell (push) or get their customers on to a substance that is addictive. The crack epidemic in the US is a direct symptom of market forces working in an unregulated drug market.
Harms to society
Economic harms
The most obvious economic harm to society is the amount of money we pay for a failed system of enforcement. We pay a ridiculous amount of money for policing, courts, legal representation and incarceration - and the only effect that has on drug supply is the price of drugs. You aren't removing demand by all this wasted activity, you are simply changing how much people need to pay to get their drugs. Once drugs are legal the money can be spent elsewhere, improving policing on other crime areas, as well as providing for a system of harm reduction for those people who do use drugs. It works out cheaper that way.
The next one is the loss of tax revenue. Because drugs are illegal there is a lot of risk in handling and supplying them. Most of the street price is not the cost of manufacture, but basically 'danger money' for the people that handle them. Add to that the cost of transportation of small batches in specialist vehicles, the bribes needed for corrupt police and customs officers and the markup from manufacture to sale is staggering. Once legal that entire markup can be translated into revenue in either punitive sin taxes or simply by making the government the only legal supplier, as some Nordic countries do with alcohol. That money can be funnelled into harm reduction, education, or anything else the government does with its money. Mainly pensions and military I am led to believe.
While researching this topic, I found a wonderful FOI request to the Home Office, submitted in 2013. I will reproduce the relevant part here. The second part of it goes on to highlight the government hypocrisy when dealing with drug use and I recommend you give it a read.
1) What is the total financial cost of loss/damage from acquisitive crime caused by Class A drug users in the UK (per year)?
1) The most recent estimate of the annual social and economic cost of Class A drug use in England was £15.4 billion, for the year 2003/04. Of this, problematic drug use (defined as use of heroin and/or crack cocaine) accounts for 99% of the total, and the costs of Class A drug-related crime is 90% (estimated £13.9 billion) of that total.
Furthermore, the most recent Home Office research estimated that between a third and a half of all acquisitive crime is committed by offenders who use heroin, cocaine or crack cocaine. There are no equivalent figures for Class B and Class C drug use.
Reproduced under the terms of the Open Government License v3.0.
The original release can be found at https://www.gov.uk/government/publications/financial-cost-of-acquisitive-crime-caused-by-class-a-drug-users-in-the-uk
I have run that £14bn in 2003 money through the Bank of England's inflation calculator, and it's roughly £24bn in 2023 money. I think it is worth hammering home the point that this is the pure economic damage from theft to feed an addictive drug habit. That is not even touching on the social cost of thieves stealing items of sentimental value as well as financial value, or damaging otherwise worthless items of sentimental value while ransacking a house. When you consider that the thief is going to get a much lower price for the item (second hand, stolen) from a fence than the cost of replacing it (new), the whole system seems utterly pointless. This cost is paid by all of us, collectively, through higher insurance premiums, or not being able to afford insurance and then having items stolen.
You can add to the social cost the elderly lady who has had her handbag snatched for the £20 in it, who now doesn't feel safe in the street any more. The lost photos when a phone or digital camera is stolen.
Social harms
This one is really easy to define. It's counted in bodies and wounded. Postcode gangs in London fighting for turf, the innocents in the background when guns go off, vulnerable people cuckoo'd by the county lines system.
We have seen grenade attacks in Stockholm over drug gang rivalries. That someone has not been injured by that yet is a miracle. Between me writing that last sentence and publishing, well, yeah, it happened. A completely innocent newly qualified teacher has been killed by "an explosion" simply because she committed the crime of living next door to a target. The worst part about this senseless taking of a life is that it was So Fucking Predictable. While most of the blame for this lies with the people who caused the explosion and the people who may have ordered it done, the politicians who keep drugs illegal for simple ideological reasons also have blood on their hands.
How much more blood and suffering is needed to appease the morons in charge? How many more maimed and wounded people are they happy to have on their conscience? All because 'drugs are bad, mmkay'?
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