Note: This interview has been edited for clarity, readability, and concision.
Scott Douglas Jacobsen: In brief, how did you get interested and involved in Canadian drug policy?
Professor Mark Haden: I worked in the addiction services for 28 years. I became acutely aware at the beginning of my career that we spend the vast majority of our money not dealing with addiction as a public health problem. We deal with it as a criminal justice problem.
All of the evidence says that doesn’t work. All of the evidence says the health approach to drugs does work. Seeing an approach not work and that is irrational because of the lack of evidence, it didn’t make any sense to me. I have this commitment to speaking the truth.
Jacobsen: If we take into account the two main approaches, one is punitive of punishment-oriented called the zero tolerance approach. The other is harm reduction. What is the preferable one to you, and why?
Haden: It is interesting. There’s no evidence to support a criminal justice response to drugs in our society. Let me clarify, I collect and organize the academic literature around drug policy issues. Since I teach at UBC, they asked me to debate a cop on the issue. They wanted me to debate cannabis legalization/criminalization. I wanted to debate all currently illegal drugs. I wanted everything on the plate. But they put us in the cannabis box.
I did my homework in advance. I found 64 peer-reviewed journal articles, which said, ‘An enforcement-based approach to drug policy and drug issues in society doesn’t work. It’s never worked anywhere on the planet. It doesn’t work in Canada. And it certainly doesn’t work in Vancouver.’
So, all of the research being done says this approach is very, very expensive and produces significant health and social problems for all of us. So, when I put down those 64 peer-reviewed journal articles in front of this cop, I said, “Can you name me one peer-reviewed journal article that says that this is the right way of approaching this problem?”
He said, “No, there isn’t any.” There isn’t any academic, peer-review, evidence-based literature that analyzes the approach. It is absolutely clear that health issues need to be dealt with health tools.
Dealing with health issues as criminal justice issues doesn’t make any sense, it costs us money. It doesn’t do us any good. We need to put our money into the programs that make an impact on the health of our society and the health of the individuals in our society.
We’re putting our money into something that makes our society less healthy.
Jacobsen: From your expert perspective, what do you consider the reason for the disjunction between the research evidence and the public perception?
Haden: The politicians, starting with Richard Nixon and Donald Trump now, have often got themselves elected by making you afraid of a bad guy. Donald Trump’s are ISIS and Mexicans. Richard Nixon’s were drug users.
Politicians often find bad guys. They say they will protect you from this evil, nasty, other ‘them’. We all feel fear. That is a human experience. Politicians use that to get votes. So, that’s a very old technique and being used by many. Stephen Harper used it.
He told us that he would protect us from the nasty drug dealers. So, it is being used from Richard Nixon to Stephen Harper. There is a huge agenda out there to make people afraid. The agenda has nothing to do with protecting people. it has to do with getting people elected.
That’s one reason. There are other reasons as well. The American prison industry is to some extent privatized. Private prisons need to be funded to get the money. How do you get money? You fill the beds. How do you fill the beds?
You need the drug war. The only way guarantee that your beds will be filled is to criminalize drugs. So, this private industry needs criminals in order to survive. As the criminals show up. The industry does well. The industry then has money.
They lobby. Lobby means they surround politicians with money. That becomes a huge process of corruption in our society. Those are two reasons. They are quite different. There’s also the factor of the complexity of the argument.
It’s very easy to throw out a fear-based soundbite. It is not a complex argument. If you say, “Be afraid of bad drug users. Aren’t they bad people? Don’t they need to be criminalized?” It is a very simple argument.
The arguments for a health approach are more complex and nuanced and thoughtful. So, in the media, when simple fear-based soundbites go up against more complex evidence-based health approaches, it is easier to express the fear-based soundbites.
Those are the three reasons for why we have a criminal justice approach to drugs in our society.
Jacobsen: Those most harmed from creation from “bad guys” by politicians tend to be the most vulnerable, downtrodden, and so on, in society, e.g. minorities and the young. What would you recommend in terms of a preventative measure at the national scale, and individuals (daily life)?
Haden: We need to end drug prohibition. Drug prohibition is the problem. That is the problem. We need to be afraid. Absolutely, we need to be afraid of drug prohibition. It hurts us as a society. It hurts us as communities. It hurts us as individuals.
It hurts us as families. It is a damaging force within society. We need to end it. Once we end it, we need to end it, not with a commercialized response, but with a public health response.
Jacobsen: What do you mean by a regulated market for illegal drugs?
Haden: A regulated market would actively control drugs based on the principles of public health and human rights. Prohibition paradoxically stimulates an illegal market that makes concentrated and sometimes toxic, drugs widely available. The goal is to greatly reduce or shut down the illegal market and regulate drugs in a way that reduces harm to individuals, families and our society as a whole. Seeing drug use as primarily a health and social issue rather than a criminal issue allows us to explore a wide range of tools to manage the problems associated with drugs in a more effective way.
Jacobsen: Is there one country or area which is ideal and provides the evidence needed for change?
Haden: No – there are many separate reports, experiences and research which indicates the need for significant change but there is no one country with is free from the domination of the American war on drugs. Some of the evidence for change is the fact that the Netherlands youth use cannabis at approximately half the rate that the youth in the USA use in spite of the fact that the Dutch sell cannabis openly. Another indicator for change is the fact that Portugal decriminalized personal possession of all drugs and this change reduced both health and social problems associated with drugs and drug use rates went down in their country. Research on police crackdowns consistently reports that this intervention does not raise the price of drugs or reduce the availability of drugs. The Senate Committee report in Canada reviewed the international literature and concluded that there is no relationship between severity of legislation and drug use problems. It is clear from the literature the enforcement interventions are ineffective and that a health approach does reduce harms to both individuals and all of society.
Jacobsen: Will our society have to deal with out of control drug use?
Haden: No – market regulations are all about controlling who has access to what drugs, in what contexts. The current system paradoxically encourages out of control use, as the contexts of use are not supervised by those who are trained to reduce harmful behaviour. In the new, post prohibition system, supervised consumption of the more harmful drugs would be the norm.
Jacobsen: What about our international agreements?
Haden: Canada has the opportunity to be a world leader in changing the outdated international agreements. Canadians need to host other like-minded countries to discuss and sign new agreements.
Jacobsen: We have problems with drugs like Valium and Oxycontin and they are legal and prescribed. What can we learn from this?
Haden: Dealers of illegal drugs are hidden and hard to negotiate with. Physicians who provide legal drugs, change prescribing practices in response to evidence and training. Who would you prefer to control drugs: trained doctors or criminals?
Jacobsen: If we shut down (or greatly reduced) the illegal market, would the criminals find other ways of doing crime?
Haden: The federal auditor general said that drug money is the life blood of organized crime. Take away the fuel which drives organized crime and you take away the incentive that brings in new players and keeps existing criminals motivated.
Jacobsen: Would a regulated market “encourage” drug use?
Haden: It is inaccurate and simplistic to say we have just two options: either criminalizing drug users or encouraging drug use. Encouraging drug use would only happen if the free market was the dominant paradigm. Instead public health and human rights should guide the process establishing a regulated market and encouraging drug use is not part of either of these models. The goal of these two models is reduction of harm to all of society and empowerment of the marginalized. We have other significant social problems like women who drink alcohol while pregnant, sexually active teenagers and youth who “huff” gasoline and we never consider criminalizing Page 5 of 9 these behaviours. The lack of criminalization is never seen as encouraging these undesirable behaviours. Public health is seen as being the appropriate approach for all of these problems and we should use this approach for dealing with drug use.
Jacobsen: What about drug use and pregnancy?
Haden: Illegal drug use is only one of many factors that influence maternal outcomes. It is well documented that when pregnant women are offered non-judgemental, comprehensive prenatal and infant follow-up, maternal outcomes improve. In fact, poverty is known to have a negative effect on pregnancy. Myths related to “crack babies” have been widely exaggerated. Abundant research has observed that the legal drug alcohol is clearly more dangerous to infants than illegal drugs.
Jacobsen: Are you proposing a “liberal” approach to our drugs laws?
Haden: No – this change is not about liberal or conservative beliefs as support for change come from all parts of the political spectrum. The opposing poles in this debate are evidence based policies vs ideologically based policies.
Jacobsen: Any recommended authors or organizations for those that might want to learn more and get involved in this?
Haden: I have been writing and publishing. My academic interest is to publish on the issue of a post-prohibition regulation and control of all currently illegal drugs. So, I publish on the issue of what it will look like, what should it look like, after prohibition ends for each of the individual drugs.
So, how we regulate smokable and injectable stimulants, such as crack cocaine, after prohibition ends will be completely different from how we regulate cannabis, which will be completely different than regulation of psychedelics, or opiates.
We as a society need to have an evidence-based, public health, regulations approach to all currently illegal drugs. It will be different, completely different. That’s the subject that we need to have the conversation around. What does regulation look like for cannabis?
That discussion is now happening in Canada. I think cannabis will be first. I think psychedelics will be second because they are not addictive. They aren’t harmful. They aren’t toxic to the body in any way.
All of the harms from psychedelics come from one thing, which is lack of supervision, context, and control. We can regulate that quite easily. That was my recent publication. How do we legalize psychedelics? I am interested in the fentanyl crisis.
The reason everybody is dying because of fentanyl is because it is prohibited. We created this problem. We can solve this problem. Now, luckily, the federal government is saying, “Yes, it looks like physicians will have access to prescription heroin.”
Because heroin addicts like heroin, they don’t like fentanyl. So, if you provide heroin addicts with heroin, the fentanyl crisis will largely go away. It won’t completely go away, but it is certainly a huge step in the right direction.
Jacobsen: Thank you for your time, Professor Haden.