Yes, that`s a good question. And the short answer is that in any place that legalizes and allows the profit industry, you will see lower prices. And because these things are so easy to smuggle in, it would put pressure on other countries that are commercially tied to the country that legalized. And in a connected world, that`s a lot of places. You`re already seeing some of that, even without legalization, of switching to plastics, which can be produced anywhere and are easier to produce secretly than with plant-based products. And legalization would be a bit like the fentanyl innovation that comes to market. This would significantly reduce production costs. And over time, that puts pressure on prices. This week, Jane Coaston speaks with Ismail Ali, Director of Policy and Advocacy for the Multidisciplinary Association for Psychedelic Studies, and Jonathan P. Caulkins, professor of operations research and public policy at Carnegie Mellon University`s Heinz College, on the pros and cons of legalizing all drugs. Proponents of legalization admit that consumption would likely increase, but counter that it is not clear that the increase would be very large or time-consuming, especially if legalization were paired with appropriate public education programs. They, too, cite historical evidence to support their claims, noting that opium, heroin, and cocaine use had already begun to decline before prohibition went into effect, that alcohol consumption did not suddenly increase after prohibition was repealed, and that the decriminalization of cannabis use in 11 U.S. states in the 1970s did not lead to a dramatic increase in use.
Some also point to the legal sale of cannabis products through regulated outlets in the Netherlands, which also does not appear to have significantly encouraged consumption by Dutch nationals. Opinion polls showing that most Americans would not rush to try previously banned drugs that suddenly became available are also being used to bolster the case for legalization. Legalization occurs in the context of the federal or state regulatory structure. In contrast, access to the substance under the decriminalization structure is generally through illicit markets. I would like to know what you think, Jonathan, about decriminalization versus legalization. Unfortunately, the U.S. government – including the Clinton administration – has done little to improve the debate. Although he has always opposed a withdrawal of the ban, his position does not appear to have been based on a thorough examination of the potential costs and benefits. The belief that legalization would lead to an immediate and dramatic increase in drug use is so taken for granted that no further studies are needed. But if this is indeed the likely conclusion of a study, there is cause for concern, other than the criticism that relatively small amounts of taxpayers` money have been wasted to demonstrate what everyone believed all along? Would such a result in no way help to justify the continuation of the existing policy and to convincingly silence those – certainly never more than a small minority – who are calling for legalisation? Not surprisingly, the broader international implications of drug legalization have also gone largely unnoticed. Here, too, there are still long questions that need to be answered. Given the long-standing situation in the United States.
How would a decision to legalize drugs as the main sponsor of international drug control measures affect other countries? What will happen to the overall regime of multilateral conventions and bilateral agreements? Will each nation have to comply with a new set of rules? If not, what would happen? Would more permissive countries suddenly be flooded with drugs and addicts, or would drug traffickers focus on countries where stricter restrictions have kept profits higher? This is not an abstract issue. The Netherlands` liberal drug policy has attracted an influx of “drug tourists” from neighboring countries, as has the now-abandoned city of Zurich after the now-abandoned experiment that allowed an open drug market in the so-called “needle park.” And while it is conceivable that rich countries can mitigate the worst consequences of drug legalization through extensive public drug prevention and treatment programs, what about the poorest countries? In this campaign cycle, New York City mayoral candidates such as Eric Adams and Andrew Yang raised the issue of legalizing and decriminalizing drugs. And last month, at VOCAL-NY`s Forum of Caring and Compassionate Mayors, several candidates were asked about their stance on decriminalizing low-level drug possession. While it`s encouraging to see candidates incorporating drug policy reform into their agenda, it`s important to clarify the difference between decriminalization and legalization – and how it can save lives. Recent meta-analyses support the hypothesis that cannabis use contributes causally to the increased risk of developing schizophrenia. In a comprehensive and systematic meta-analysis, Moore et al.37 determined whether cannabis use causally contributes to the development of non-substantial psychiatric disorders such as schizophrenia and mood disorders. The study was designed to address, to the extent possible, two of the most important methodological problems in studying the relationship between cannabis use and psychosis: 1) the potential for reverse causality (where psychosis causes cannabis use and not the other way around) and 2) the transient effects of intoxication (which are misinterpreted as psychosis as a false positive error). The results showed that the risk of psychosis in cannabis users was increased by approximately 40% (pooled adjusted OR: 1.41). The results were not as impressive for mood disorders. A dose-response effect was observed in users, with the risk more than doubling in the most frequent users (OR = 2.1). For cannabis and psychosis, there was evidence of confusing effects, but associations persisted in almost all studies, even after adjusting for full lists of variables.
The authors concluded that “there is now sufficient evidence to warn youth that cannabis use may increase their risk of developing psychotic illness later in life” (page 319). As the debate over “legalization” and “decriminalization” progresses, the terms are often misused interchangeably. However, there is more than one semantic difference between the two. Legalization would mean possession or use of the drug in accordance with marijuana use guidelines and restrictions. Typically, these guidelines are codified by a state law that determines how much marijuana a person can possess. If marijuana is legalized in a particular state, people who use marijuana as permitted by state law will not be prosecuted for not engaging in illegal activities. Opponents of more permissive regimes doubt that black market activities and related problems will disappear or even decline sharply. However, to answer this question, it is still necessary to know the specificities of the regulatory system, in particular the conditions of supply. When drugs are sold openly on a commercial basis and prices are close to production and distribution costs, the potential for illegal undercutting seems rather slim. Under a more restrictive regime, such as state-controlled outlets or medical prescription systems, illicit sources of supply would be more likely to persist or expand to meet legally unmet demand. In short, the desire to control access to containment consumption must be weighed against emerging black market opportunities.
Systems that risk a persistent black market require more questions – about how new black markets work over time, whether it is likely to be more benign than existing ones, and more generally whether the trade-off with other benefits is always worth it. The belief behind decriminalization, according to the Biden administration, is that “no one should be imprisoned solely for using illegal drugs.” Instead, federal courts will refer drug users to drug treatment courts so they can get the right treatment to treat their substance use disorder. Biden`s goal is to promote this domestically so that all states can help addicts get the help and support they deserve. It is not intended to encourage greater drug use. Yes, stimulants are a broad category. And some of them are tougher than others. I mean, on some level, caffeine is a stimulant, but it`s not a very strong stimulant to talk about informally, whereas methamphetamine certainly is. Adderall is more at the caffeine end of the spectrum, thankfully, although there`s actually a distraction from Adderall. But it`s a different feeling. It`s like someone having access to Adderall selling it or giving it to their friend in college to help them learn because they think it`s going to be a smart performance-enhancing drug. But overall, but I think that`s the goal.