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April 2, 2007 - Victoria Times-Colonist (CN BC)

Column: Let's Try Anti-Smoking Tactics With Other Drugs

By Paul Willcocks, Times Colonist

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What if we treated other problem drugs like tobacco? The province's latest move to ban smoking in all enclosed public spaces was a reminder of how successful we've been in dealing with cigarette smoking.

Watch an old movie and everybody is smoking. Even 20 years ago, people smoked at work, in bars. The people who asked for the non-smoking rooms in hotels were a little strange and often disappointed. Smoking was still cool and socially acceptable. But we decided smoking was bad -- it's addictive, gives you cancer and a brace of other illnesses.

Taxes made it more and more expensive, until it got hard to deny you were hooked. Not many people would happily spend $60 a week unless there was addiction involved.

Life insurance started to cost more. You couldn't smoke at work. Restaurant smoking areas kept shrinking. People started to talk more about all those hospital beds taken up by smokers; the current estimate is that 40 per cent of hospitalizations are smoking-related. (The argument that smokers really save the system money because they die years earlier than non-smokers was interesting, but hardly likely to make tobacco use seem like a smart idea.)

And then, finally, there was another big shift. Smoking became largely a mark of loserdom. Not entirely -- tautly wound artists and edgy blues performers still get away with smoking. But broadly, smokers are people you would be less likely to hire.

In a relatively short time, we took a deadly drug that was almost completely accepted, hugely used and highly addictive and slashed its use. About 15 per cent of British Columbians say they smoke, substantial but down sharply from the past.

We could have made tobacco illegal 20 years ago. But we chose a different approach -- managed use, with education and financial penalties to decrease smoking. And it's worked quite well.

So why not try the same approach with illicit drugs, or at least some of them? What if we say heroin and cocaine are like tobacco -- things we really wish people wouldn't use, but that we still accept some probably will.

Under that approach we would commit a lot of resources to making sure people didn't start, as we did with smoking. We'd target kids, but also vulnerable adults.

We'd make a big effort to help people quit, something we don't do today. And for people who wanted to keep using, we would prescribe heroin or cocaine or working substitutes. (The current half-hearted, restrictive methadone program really doesn't count.)

What are the downsides? It simply seems wrong to provide a drug like cocaine to people, for one thing. You could argue that others -- young people -- might see the practice as condoning drug use. (Though we've managed to allow controlled sale of tobacco products while condemning their use.)

Against those negatives, look at what we would gain. The people being prescribed the drugs wouldn't be stealing to get the money to buy them. Figure a 75-per-cent drop in property crime, conservatively, since Victoria police estimate up to 90 per cent of break-ins and thefts are drug-related. Police would be free to work on other problems and jails would be less crowded.

Organized criminals would lose a huge market. There would still be demand, but not enough to make the business attractive. Instead of spending their days and nights scrambling for money and drugs, users would have time to think about work and developing more stable lives.

Based on similar efforts in other countries, a significant number would seek treatment.

During a prescribed heroin trial in Switzerland, not only did crime by users plummet but about seven per cent quit during their time in the program.

Since people wouldn't be using drugs in alleys and dodgy settings, we'd save a fortune in health costs. Fewer overdoses, abscesses and infections. People with both mental health problems and addictions would get a chance to reduce the chaos in their lives and deal with their mental illness.

And all the while we'd be pushing for the same shift in attitudes toward drugs as we have achieved on smoking. It should be much easier. About 55 per cent of adults smoked in 1965, compared with 15 per cent in B.C. today. Only about two per cent of Canadians are heroin and cocaine users; if we can make the same relative gains, using the lessons from smoking, the number of addicts would be tiny.

That seems like a long list of benefits, with few costs. Yet instead, we push on with tactics and strategies that have failed to deal with prohibited substances for almost a century. We fight to reduce supply, unsuccessfully, and create crime and chaos and costs.

For whatever reason, we tried something different with tobacco. Maybe the big companies had too much clout, or there were just too many smokers. We didn't ban cigarettes or arrest people. We worked on reducing demand. And it worked.

Why not for other drugs?

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