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intl_drug_control_21st_centuryBook review  
International Drug Control into the 21st Century - edited by Hamid Ghodse 
 
Published by Ashgate, Aldershot, UK .
ISBN 978-0-7546-7215-9
 
Review by Peter Stoker, Director, National Drug Prevention Alliance.

The first surprise in reviewing this book is the breadth of issues which the INCB addresses. The simplistic image of INCB is that they are no more than a grouping of authoritarians, inventing rules then watching hopefully for compliance - this collation of studies, drawn by Professor Ghodse into one edited volume, gives the lie to that. INCB are clearly deeply and actively concerned not just with the medical but also with the social and economic aspects of drug policy, are involved in ensuring adequate supply of drugs for legitimate medical use, and are alive to the complexities of drug prevention and health promotion. Moreover they don't huddle in their own comfort zone, they face challenges to their position, not least proposals for legalisation or other liberalisation of drugs.
 
As a professional in the addictions field for 35 years, a Professor of Psychiatry and Drug Policy, and several times President of the International Narcotics Control Board, few if any can match Hamid Ghodse for experience or authority. This book draws together the strands of thinking in INCB over the past two decades. Each year since 1992 INCB has defined a theme for study. Professor Ghodse has collated and combined these studies into one eminently-readable volume. Anyone serious about understanding the full spread of this field should have this book on their desk - and regularly read it.
 
The stated purpose of the INCB is "... to protect the well-being of individuals and society". Some contest this in terms of 'free choice' or 'human rights' - INCB's response is that the prevention of drug abuse problems is protecting the human rights of society as a whole. INCB has powers to sanction under-performing countries and to force compliance, but this power has never yet been fully applied. As always, demand reduction and prevention is a poor relation, generous lip-service but relatively small resourcing - this despite many states arguing that this work should have its own Convention.
 
The 1988 Convention was the first co-ordinated attack on traffickers. Trafficked drugs are often stored in staging points were laws are weak. Traffickers need to be tackled at international level; acting only at national level is, as Hamid Ghodse observes, "pruning the branches but leaving the roots intact".
 
Controls have become more effective over the decades; diversion is greatly reduced, meanwhile the practice of therapy has successfully replaced some of the over-consumption of drugs through repeat prescription. Alternative products in cultivation countries are an attractive solution, but this has yet to be implemented to any effective degree by any country. Zero percent drug use has never been achieved, one to two percent, as in USA pre-1950s, is probably a more realistic target.     
 
There is no evidence that illicit drug production improves local economy; the current suggestion in the US State of California that legalising and taxing cannabis use would lift them out of financial problems is extremely dubious; more likely is that there would be gains for a few but losses for many.
 
Demand Reduction and Supply Reduction are symbiotic - but the key importance of demand reduction is recognised throughout the international community. To be effective, Demand Reduction needs to engage with community empowerment, education, media, health promotion, culture, and treatment/rehabilitation. Success depends very much on political will as well as community co-operation. Harm reduction is an acknowledged part of the process but INCB emphatically says "Harm Reduction is no substitute for demand reduction". Under Article 3 of the 1988 Convention it is possible to address what some in the media are doing as 'inducement or incitement to use drugs'. INCB consider that governments should be pro-active, rather than just leaving the advocacy role to people who wish to dismantle or otherwise subvert the Conventions.
 
INCB emphatically state that "The most promising prevention is culture change" and by 2004 governments could be seen waking up to the possibilities of shifting culture. INCB refer to the reduction in the tobacco use as an example of what has been achieved. If a prevention programme and its evaluation is of longer duration than the election cycle in a given country, then politicians and government agencies will be less interested. Prevention must be sustained, or else complacency and tolerance develops.
 
In pressing for liberalisation, many criticise prevention and demand reduction for not succeeding in 100 per cent of the efforts, (and yet it is interesting how this failure to succeed in 100 per cent of efforts never appears as a criticism of a harm reduction programme). INCB observes that not enough has been done to disseminate successes. Semantics and memes, a standby of liberalisers' weaponry; do not impress INCB. "Legalisation arguments don't withstand critical evaluation and run contrary to general expectation. Proponents have yet to produce viable proposals. Liberalisation would irrevocably impact public health, social wellbeing and international stability."
 
The Internet age has given new ways of conducting crime - in the UK more than 1000 websites selling drugs have been identified. At the same time the regulations and the application of regulations leaves much to be desired; in a survey of 52 countries, 33 had done nothing, 9 had done little and 10 would only address major crime matters