LEGALIZATION OF "RECREATIONAL DRUGS"; SHOULD IT OCCUR?
Saidemberg , M.D.*
From my standpoint, the reply to this inquiry is
No! A true approach against recreational drugs still has to be developed. It
does not make sense to legalize drugs as an act of spiritual benevolence or
national surrender. The general community and also the chemical dependants are
entitled to have facts, not fiery opinions.
The direct connection between consumption of
drugs and the increase of crime is well established. We must keep in mind that
generally crimes in Brazil tend to be committed under alcoholic beverage
influence, a legalized recreational drug. Also, that in the community, the group
most inclined to violent behavior is the chemical dependants one. On the roads,
accidents with victims including fatally wounded ones are caused mainly by
driving under influence of alcohol, but, in second place staying the use of
other psychoactive substances. The drug recovery programs therapeutic success
reaches up to 70% for chemical dependants in 2 or 3 years treatment follow up.
However, the treatment dropping out rate from the start of the abstinence period
tends to raise, due to antagonism and problem denial of many chemical dependants
and their impatient and many times extenuated relatives. Generally, the follow
up program is abruptly terminated whenever there is any habit relapse.
The reduction of the demand for drugs through
primary prevention is a well established fact, but, really, the government and
the society need to support the establishment of programs that are
scientifically evaluated as they go on. Those programs must have a proper table
of contents and remain part of the educational system program and not as an
eventual non methodical activity. Nevertheless, there should be a deep respect
for all initiatives to argue with responsibility and knowledge the question of
the recreational substance use.
In Brazil, June of 1998, the federal government
created the Secretaria Nacional Antidrogas (SENAD) and signed a pledge
with the United Nations to eliminate "the affliction caused by the drugs", in a
10 years period. However, this Secretariat relies on insufficient financial and
material resources to carry forward its task. Moreover, the method was not
defined as how to diagnose the drug consumption rate in Brazil and other
essential researches, starting point for the foundation of the national
Demand Reduction, the national program of
prevention of drug use and abuse must be treated as a different program, not
subordinated to the politics of traffic repression, as it already occurs in
U.S.A., Great Britain and Canada. A National Agency for drug addiction
prevention should have its proper agenda and life.
We need to have in mind that the lawful consent
must remain for legitimate medicines under medical supervision and with
increasing restrictions for alcohol and tobacco, both enjoying an enormous and
undeserved social acceptance. The defenders of recreational drugs legalization
indicate that despite the continuous repressive efforts, the use persists to
grow. Thus, why not to wave the white flag in the fight against drugs? Why not
to offer the unconditional surrender to the drug trafficking? The drugs are
cheaper and more abundant in the streets of the Brazilian communities, would not
be this the very moment to quit all the efforts in the repressive control of
drug trafficking? The truth is that Brazil has not undertook a really efficient
fight against drugs. The lack of a broader and mobilizing strategy from this
society has been one of the causes for the defeat imposed by the drug traffic.
Instead of a concentrated effort in the preventive educational measures to
thwart the use in our schools, homes and workstations, we identify attitudes
that vary from indifference to the most contradictory feelings and ideas. The
pro-legalization movement takes hold due to scant social opposition. This
confirms that the message on the destructive and mistaken use of drugs has been
undermined. Progressively, the youth has learnt to ignore problems in the use of
The favorite myth associated to the movement pro
legalization is that the revenues from the official "recreational drugstores"
and the taxes will help to stimulate the economy. This claim is at the very
least naïve and certainly, not supported by the facts. The envisioned economic
benefit would be overcome by the billions of "Reais" or dollars expenses to
repair the social losses, added of course to the severe harm to the health, the
precocious handicapping of new generations and finally millions of lives
curtailed by drug use. We cannot deny evidences, we should not be lax towards
politicians that are compromised with the organized crime or when they choose
not to recognize reality due to their own idiosyncrasies.
There is the widely spread idea that genetics
have something to do with the drug-addiction fatality, compounded with the
psychological traumas and other psychiatric conditions concurring for a
deterministic result. These are concepts that tend to conceal the fact that the
availability of a substance plays a much more preponderant role favorable to the
drug culture. To a certain extent, the allure for what in science is more
measurable makes this elementary truth to remain dimmed.
To prevent the occurrence of new cases, to treat
and to recoup chemical dependants are necessary measures to push away the misery
caused by drugs. However, always there are some backtracking at different points
of the best approaches, and that goes for all attempts to deal with any illness.
The criminal groups have become stronger and already they are very well armed.
They openly defy the police and the justice system.
Ironically, the most efficient war against drugs
has taken the crime to a gradually improved performance. As a more notable
example of this backtracking, we have the increasing traffic repression, that
has stimulated the commerce of more concentrated drugs. The reduction of the
volume of the product decreases the possibility for detection. The same has
happened when the treatment of infectious diseases stimulates the development of
more pharmacologically resistant micro-organisms. In spite of that, the fight to
save lives must continue.
We are remembered that during the "Prohibition -
from 1920 up to1933" the alcohol consumption was more abated in the case of
lesser alcoholic concentrated beverages, such as beer, while predominated the
market of smuggled or illegally distilled beverages ("bootlegging "or"
moonshine"); the latter consumption still to a much lesser degree when compared
to levels prior to 1920. Soon after the repeal of the "Prohibition" (enacted in
1933), low alcoholic concentration returned to be the standard for the larger
consumption of drinks, next to the previous levels to the year 1920.
However, the general alcoholic beverage
consumption only regained its intensity ten years after the Prohibition Repeal.
(The law known in U.S.A. as "Prohibition" was the result of the ratification of
18th amendment to the USA Constitution That change forbade the manufacture and
sale of alcoholic beverages. From a practical standpoint towards alcoholic
beverage consumption reduction, Prohibition functioned quite well. However, it
was repelled by having fallen in unpleasantness with the population, probably,
due to the US government lack of efficient educational programs to keep the
From this experience, it is inferred until a
certain point that the current trend for more powerful drugs would be directly
related to the restrictive barriers imposed upon the drug. Certainly, other
historical factors largely neglected by the world need to be taken in
consideration. For instance, when a prohibitionist law is about to be approved
or enforced, most probably the consumption of one particular drug has already
become more generalized, being a well known danger to the health, displaying an
epidemic character and when other personal and social damages are clearly the
The unlawfulness thus is considered in
consequence of the more or less obvious associated harm to a substance use, only
after such a consensus is reached, there is a firm attempt to interdict its
access. It was for this perception that the Chinese government in 1839
proclaimed the prohibition for the opium trade. Such measure provoked a British
military intervention towards liberating such a commerce again; besides, being
demanded from the Chinese government several concessions, even territorial ones,
as a way to repair for the economic losses caused to the British Crown. In the
case of the legalization of recreational drug trade in Brazil, ironically, also
the national community will see itself in the contingency to make suitable
amends for the resulting material and moral losses suffered by the drug
traffickers during all those years of repression. On the other hand, the drug
traffickers do not assume responsibility for their victims.
Additionally, in favor of repression, there is
the strong and responsible desire to protect the infancy and the youth from
drugs. Finally, always when a drug is wide and eagerly accepted, as it occurs in
the case of alcohol, there should be a strategy to unchain social co-operation
in order to remove it from the shelves, otherwise revolt will easily prevail.
The rebellion can defeat the attempts of control. Is it possible to deprive
people of a product that takes 10% of its users to a serious physical
dependence? Suppose there is a great acceptance for a much larger number of
users? Tobacco will be even more difficult to be curbed in its use, as it causes
strong physical dependence in the majority of the smokers; and usually its awful
effects to health are less conspicuous. Would its interdiction bring still more
revolt and a blatant lack of social compliance?
Instead of inspiring defeatism, this historical
occurrence of the revocation of "Prohibition" in U.S.A. may generate more
efficient measures to restrain other dangerous drugs that should not persist in
greater availability and acceptance. Certainly, we do not need more drugs that
kill and maim on the roads or make easier for violence and other crimes. A
lesson that should derive from "Prohibition" deals with the need for the
community to be set in motion as an essential part of the drug control program.
In the first few decades of last century, there was not yet the idea of
effectively instructed community action in the fight against recreational drugs.
The politicians, judges and in all levels, the
law enforcement agents need recognition and to be esteemed in their role They
should be helped in problem solving for the sake of social safety. They should
not be left ignored and unsupported, as they usually are to the point of being
forced by circumstances to make special agreements with criminals in order to
guarantee their own safety and survival. In consequence, a policeman will sell
and supply protection against drug apprehension. A defendant with good financial
resources will buy false witnesses or will try to bribe a district attorney or a
In the beginning of the twentieth century,
Brazil National Secretary of Health, Dr. Oswaldo Cruz tried to fight the
epidemics spread by rats. For that initiative, he had to face political
opposition and also his program had to deal with producers of rats. Then, due to
a financial incentive to get people's compliance in mice catching, there came
the figure of the mice producers, they raised mice and afterwards would exchange
"captured rats" for money.
Thus, it is not fully truthful that only with
drugs, "the corruption is the cancer and the money the carcinogen". Yes, there
is corruption among public officers: judges, policemen, employees of the
penitentiaries, law enforcement agents and others in public office. We can even
consider that money is an efficient tool for corruption. This is not solely the
inevitable and destructive consequence of the politics in favor of drug
Whenever the community remains aloof and non
participant in decisions that will matter to its own fate, the institutions will
be dominated by the organized crime. In consequence, a policeman will sell and
supply protection to criminals.
To only trust a law to be implemented by the
government and its official agencies is to choose a fragile move. Without a
powerful alliance with the community, the fight against crime will not have a
real impact. The "Prohibition" was defeated by the moralist thirst for scandals
of its time, when alcoholism was seen more as a character weakness and not as an
illness with a fatal chronic course.
Inside our safer penitentiaries, the ample
availability of drugs is a powerful example of the economic swaps and the
corruption that the money can buy. Unfortunately, Brazil is exporting this
corruption. The Brazilian dollars of the drug trafficking pay for murders, for
kidnappings and bribes related to the drugs in other countries too. Instead of
taking responsibility and recognizing that the proper demand and production are
the real cause of the problem, it has been attempted to export guilt. To deal
with the real issue, we must focus in the national problem and its causes.
Without our own demand there would not be any external production directed
towards the domestic market. Without the national production there would not be
any demand to be met, either internal or external. Nevertheless, it is much more
comfortable to severely incriminate other nations that are not fulfilling their
role in fighting against demand and traffic of drugs. It has a main persecutory
conclusion: "the developed nations are not reducing the demand and our
neighboring nations are not diminishing the production and the traffic".
Of course, with prohibition the illicit drugs
only would be obtained through the black market. Then, the prices will continue
to be established by this market, having as a result high values and profits.
Since the drugs are thus expensive, many users will have another motivation
beyond the simple friendly desire of sharing: there prevails the wish to
transform friends into drug consumers, and by doing so drugs will be sold to the
newcomers, what will help to defray the former users' own drug addiction. There
will be no control upon adverse effects, and the most active enticement towards
initiation of new users is another of the consequences of the prohibition.
Generally, the consumers are the same ones that will be dealing with drugs for a
Nevertheless, if drugs were liberated, friends
more effectively would be enlisted to share a ceremonial use. In such a case,
the party will be fully subsidized by the government. Naturally, the excluded
ones, children and adolescents will continue available for a newly defined
black-market. We will have a similar tragedy as the opium in China, which
eradication was at the highest human and economic cost.
The high prices of the black-market withhold the
choice concerning determined drugs. Notwithstanding, the chaos will prevail as
more drugs become freely available for recreational use. Already we have the
examples of tobacco and alcohol, children of all ages are fully under the
incantation of these two substances, in spite of laws that supposedly should
prevent individuals below 18 years to use them. Even in the maternal womb, the
child from conception until birth is frequently subjected to the extremely
harmful impact of those two socially well accepted substances.
The Legalisers defend that there will be a great
loss of motivation for any illegal drug business, once the "Drug Prohibition
ceases". In reality, one of the more harmful aspects of the drug black market is
the allurement for easy money, attracting the young of the inner cities.
Supposedly, with the Legalization, this money source will dry. The proponents of
the Legalization emphasize that the drug is not necessarily bad, some measures
could mitigate current risks for its use, "the reform of the laws on drugs"
would bring a greater acceptance for the chemical dependent and for one's
freedom of choice. Also, they emphasize the resulting benefits from the mental
health workers' team and from the programs of "harm reduction" directed toward
those that choose to remain chemically dependant. Many of the proponents of the
Legalization are professionals of the health area wishing to guarantee a
legitimate professional support for the chemical dependants, acknowledging that
they are in a serious mental turmoil, therefore, their personal drama should not
be aggravated by the severity of the law. They seem not to have any doubt about
the fantastic results of their proposition, even though the already legalized
substances represent a definite enormous health hazard.
The Legalisers want to convert everyone to the
belief in the great reduction of motivation for the ones that are in business
with illegal drugs, a commerce that supposedly immediately would be substituted
by the supply of those same substances with extremely low prices or by their
free distribution, totally sponsored by official agencies, with proper
guidelines to drug users for a safe experience. Quite efficient governmental
action completely free of bureaucracy; warehouses amply supplied with all
recreational substances, including the most lethal ones, furthermore,
functioning 24 hours per day, no space would remain for the drug trafficking.
Regarding such a proposal, is there any place left for doubt or skepticism?
Anyway, the drug law in Brazil has become
gradually less efficient. There have been judicial initiatives to legalize
marijuana for "medicinal use", unfortunately, a cover-up for liberating its
recreational use. This trend reversal might compromise the future of this
generation. Of course, we need to realize the legitimate support that the drug
users should receive, even when there is no desire to overcome their drug
consumption. Nevertheless, nobody should ignore one's moral and legal
responsibility for disseminating drug use. All these individuals need to be
confidant that they are getting all the help through programs meant to control
the dissemination of HIV and other transmissible illnesses. However, we cannot
use the legitimate support due to the chemical dependent as a maneuver to
liberate the access towards recreational substances.
The new generations deserve efficient and
energetic measures taken to retain the prohibition to substance use and to its
traffic. We need to eliminate the confusion on the essential drug prevention
programs, that for certain will continue to keep the ideal of total abstinence
and the necessary medical attention in order that each chemical dependant is
humanly taken care of. In fact, for the mental health professionals there is no
alternative besides to respect the individual free decision on compliance with a
drug abstinence program. However, even if a person does not want to cease this
use, the overture for medical help should never be dismissed by the caretakers.
The traffic of drugs is a fantastic business,
probably the greatest of all. The enormous profit depends on customers' faithful
adherence to the substance. If there is little repression, the availability of
the substance raises, the price will be affordable and many children and
adolescents will choose to engage in its use. The lesser is the cost to
cultivate and to transport drugs in this country, the lower will be their final
price in the street. Conclusively, to reduce the drugs influx and their national
production in Brazil must be a maximum priority. Until the availability of drugs
is dramatically reduced, with its price staying high, preventive instruction and
the efforts for law enforcement will not be able to meet success.
It is basic to consider a continuous investment
in strategies that lead to abstinence. We need to find ways to persuade each
citizen that the use of drugs is wrong; it destroys lives, families, schools and
communities. To label a dangerous drug as "soft" and to defend its use as
"medicine" is a manner to convey a misguiding message to our young.
Someone might wonder how much would it be
necessary for children, adolescents and adults to fall into the trap of "more
soft" recreational mind altering substances. I would ask from everyone: have you
examined yourself to detect any curiosity to make personal changes through those
substances? Perhaps you have either the feeling of not belonging or are
attempting to deal with loneliness; even, there might be a strong desire to
receive compensation for something unacceptable in yourself or in the world.
In "Agony From Ecstasy", by Lynn Smith, we can
read the personal drama of a young woman that until her meeting with "Ecstasy"
had a normal life; as a result she became ill, fortunately, again she was able
to enjoy a good level of recovery. Some excerpts: "I hear people saying that
'Ecstasy' is a harmless, happy drug. There's nothing happy about that 'harmless'
drug chipped away at my life. Ecstasy took my strength, my motivation, my
dreams, my friends, my apartment, my money and most of all, my sanity. I worry
about my future and my health every day." Let us move now to another example,
one I take from my own office: a 19 year-old lad, that developed a psychotic
break after several years of marijuana use. Once more, under marijuana influence
in a time when already there was a reasonable recovery from psychosis, he makes
a quite serious impulsive attempt to commit suicide. Afterwards, he affirmed
that at the suicidal moment, he had a strong idea that he was an angel returning
to heaven, where he would be able to smoke marijuana with other heavenly
creatures. Several months have elapsed since then, however, he still maintains
the strong belief that marijuana can do no harm. In favor of that conclusion, he
would quote statements from the media, of course only those friendly to
One unavoidable question needs to be made over
and over again: every citizen of this country is making enough effort to prevent
new cases of drug use? If the reply is no, instead of keeping the complaint that
the other one is at fault, we need to make more and to give full support to the
fight against the traffic of illicit drugs and in a general way, against the
culture favorable to recreational drugs.
NB: (the abuse of drugs is the use of a
psychoactive substance - legal or illegal - such use being sufficient to cause
to the abuser physical, mental, emotional or social damages. Addiction or
dependence is the compulsory and continuous use of a drug.)
* The Dr. Silvio Saidemberg, psychiatrist and
psychotherapist, professor of psychiatry at the College of Medical Sciences; PUC
01. Botvin, G. J., Griffin, K. W.,
Diaz, T., & Ifill-Williams, M. . Drug abuse prevention among minority
adolescents: One-year follow-up of a school-based preventive
intervention. Prevention Science, 2, 1-13. 2001
02. Botvin, G.J., Griffin, K.W., Diaz, T., Scheier, L.M.,
Williams, C., & Epstein, J.A. . Preventing illicit drug use in adolescents:
Long-term follow-up data from a randomized control trial of a school population.
Addictive Behaviors, 5, 769-774. 2000
03. Bradley, C.J., and Zarkin, G.A. Inpatient Stays for
Patients Diagnosed With Severe Psychiatric Disorders and Substance Abuse. Health
Services Research 31(4):387-408. (1996).
04. Cummings, K.M.; Hyland, A.; Saunders-Martin, T.; Perla,
J.; Coppola, P.R.; and Pechacek, T.F. Evaluation of an enforcement program to
reduce tobacco sales to minors. Am J Public Health 88:932-936, 1998.
05. Forster, J.L., and Wolfson, M. Youth access to tobacco:
Policies and politics. Ann Rev Public Health 19:203-235, 1998.
06. Hall W, Johnston L, Donelly N. The epidemiology of
cannabis use and its consequences. In: Kalant H, Corrigal W, Hall W, Smart R,
eds. The health effects of cannabis. Toronto: Addiction Research Foundation,
07. Hughes, John R. ; Nicotine Related Disorders;
Comprehensive Textbook of Psychiatry, Kaplan & Sadock; Seventh Edition, editors
B. J. Sadock , V. A. Sadock. By Lippincott Williams & Williams, pp. 1033-1038;
08. Jacobson, J.L., and Jacobson, S.W. Drinking moderately and
pregnancy: Effects on child development. Alcohol Res Health 23(1):25–30, 1999.
09. King, C.; Siegel, M.; Celebucki, C.; and Connolly, G.
Adolescent exposure to cigarette advertising in magazines. JAMA 279(7):516-520,
10. Lancet, The (UK), Dangerous Habits. Editorial. vol. 352,
11. Longabaugh, R.; Wirtz, P.W.; Zweben, A.; and Stout, R.L.
Network support for drinking, Alcoholics Anonymous and long-term matching
effects. Addict 93(9):1313-1333, 1998.
12. Millberger, S.; Biederman, J.; Faraone, S.V.; Chen, L.;
and Jones, J. ADHD is associated with early initiation of cigarette smoking in
children and adolescents. J Am Acad Child Adolesc Psychiatry 36:37-44, 1997.
13. Pierce, J.P.; Choi, W.S.; Gilpin, E.A.; Farkas, A.J.; and
Berry, C.C. Tobacco industry promotion of cigarettes and adolescent smoking.
JAMA 279(7):511-515, 1998.
14. Schukit, Marc A. - Alcohol Related Disorders: In: Kaplan &
Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition: 953-971, 2000
15. Smith, Richard, Editor. The war on drugs: Prohibition
isn't working, some legalisation will help. British Medical Journal, volume 311
23-30. December 1995
16. Steinglass, P. Family therapy: Alcohol. In: Galanter, M.,
and Kleber, H.D., eds. The American Psychiatric Press Textbook of Substance
Abuse Treatment. 2d ed. Washington, DC: American Psychiatric Association, 1999.
17. Stratton, K.; Howe, C.; and Battaglia, F. (1996). Fetal
Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment. Institute
of Medicine. Washington, DC: National Academy Press.
18. Swan, G.E., and Carmelli, D. Behavior genetic
investigations of cigarette smoking and related issues. In: Noble, E.P., and
Blum, K., eds. Handbook of Psychiatric Genetics. Boca Raton: CRC Press, 1997.
19. Szasz T. The morality of drug controls. In: Hamowy R, ed.
Dealing with drugs: consequences of government control. Lexington, Mass:
20. The case for legalisation The Economist print edition, Jul