Psychology and Policy

[jducoeur]

Heard a very interesting article on BBC World Service this morning, talking about the Swiss experiment with drug regulation. They've apparently taken a super-pragmatic approach to heroin addiction, focusing on crime reduction and harm mitigation, and it's reportedly working quite well.

Basically, they provide free heroin/methadone treatment and free needles to addicts, but manage it stringently. Addicts have to queue up at the pharmacy each morning to receive their fix, and they are closely monitored. The attitude is very professional, treating it as a health problem.

Results: new cases of heroin addiction have plummeted -- I believe they said that it's fallen five-fold since they started. The reason seems to be simple psychology: the sight of the addicts lining up to get their daily fix has made heroin totally uncool, with the result that the younger set are avoiding it like the plague. Early criticisms that a legalized approach would lead to more addiction have been pretty effectively refuted. And heroin-related crime has mostly gone away, since it's easier (if more humiliating) to get the legal fix.

Very nicely done, and instructive to the overall drug argument. It's a good illustration that legalization can work well, if you think the problem through carefully. Now if only the US could apply a similar degree of sense to its drug policies...

Comments

[rufinia.livejournal.com]

::plops into memories:: My non-thesis class this fall will be Substance Abuse- not because I have a real deep interest in it, but because this is one of the Big Things in policy-making, and I should be at least somewhat informed. "I make the law! I am the law!"

[dagonell.livejournal.com]

And I could give a thousand reasons why de-criminalizing marijuana actually helps the economy. The real problem is, politicians work hardest on getting re-elected. Legalizing drugs is like handing your opponent a weapon, "My opponent is soft on hardened criminals! I am not!"
-- Dagonell

[umbran.livejournal.com]

Now if only the US could apply a similar degree of sense to its drug policies...

It could, if the voting populace didn't have its collective head shoved in an anatomically inappropriate place on the subject. We generally cannot separate our personal moral judgements from the overall practical solution.

The number of problems that could be solved if we could recognize that "punishment" is not always a useful solution is staggering.

[jducoeur]

Yaas. It constantly appalls me to see that the US learned essentially nothing from the experience of Prohibition...

So what takes its place?

[metageek.livejournal.com]

OK, so heroin addiction rates have gone down. Has some other drug taken its place? (Granted, moving people from heroin to, say, marijuana is a big improvement...)

Re: So what takes its place?

[jducoeur]

Dunno -- the radio article didn't get into that. (Although the same question did occur to me.)

I don't think it's obvious that anything *would* take its place, though, at least to a complete degree. Some number of addicts are people who desperately need a high of some sort; they seem likely to go find something else. But some are simply looking for something cool to do, or are trying it due to mere social pressure -- in those cases, there's no obvious reason why the same impulses wouldn't be channeled into non-drug outlets instead. Indeed, it seems likely that this has some effect on the memetic level, of making the whole addictive-drug thing uncool; that effect is probably only on the statistical level, but I would expect it to be real.

But yes -- it would be interesting to see a study on how usage of other drugs tracks with the fall of heroin in this case, to understand those correlations...

Re: So what takes its place?

[metahacker.livejournal.com]

World of Warcraft.

Re: So what takes its place?

[metageek.livejournal.com]

Oh, but that's OK, because the Corporate Masters make money on it.

[lauradi7.livejournal.com]

Wouldn't implementing it here require a coordinated national health system? I'd be happy to have one of those, too.

[jducoeur]

I don't think it's clear that it would. The only thing the federal government would clearly have to do is get out of the way and legalize such controlled measures at the state/local level.

There would be some problems with implementing it strictly locally: in particular, it would tend to draw addicts to those locales. So it would probably be *better* if implemented widely, to spread the load around. I don't think that requires national co-ordination, though, just enough places doing it so that no small number of locales get overwhelmed...

Coordination

[metageek.livejournal.com]

You might think a national health system would make it easier, by reducing the number of organizations that'd have to coordinate; but it'd probably be more likely to run afoul of "we don't do that"ism. A private health system would have a profit motive to get it interested.

(Personally, after seeing the poor treatment my Canadian relatives and friends have gotten, I have no interest in seeing us get a national health system.)

Re: Coordination

[lauradi7.livejournal.com]

I think that's definitely a ymmv thing. I know someone in England who is very happy with the care she's received from the NHS over the years. When her kids were small, she said that she was sure they were better off - they couldn't afford much in the way of private health care and would have often just skipped the doctor visit instead of paying out of pocket if they lived in the US. I'm happy with the private care with have here (a PPO, doctors at Harvard Vanguard) but it costs us many thousands of dollars a year for the three of us. Most people in the US (or anywhere) can't pay that kind of money.

[metahacker.livejournal.com]

We...um...we have methodone clinics. I'm unclear on what the difference about their approach is. New funding? Cleaner uniforms? They give it out at the front door, not the back?

[jducoeur]

Good question. There are clearly some differences, and they may be crucial: in particular, I gather that they've largely decriminalized it (which changes a lot of economic incentives), and I believe they're actually prescribing controlled amounts of heroin in some cases. (I'm seeing one or two reports around the Net that seem to indicate that this works better than methadone for helping addicts get their lives together.) But I can't say I know what they've done in any depth.

It would be useful to understand the differences better, since it seems to be working better there, and I suspect that the details matter...