We have been working for many years on proving that our approach to the use of psychoactive substances does not work.
For decades Canada, the United States and most western countries have valiantly tried to use prohibition and criminalization to control the use and abuse of certain substances. All that has been proven is that this does not work.
If prohibition had been working, we would have seen less drug use, fewer associated harms. Nor would illegal markets, organized crime and related violence have flourished. Prohibition has even led to increasing harm to public health from the spread of HIV and hepatitis C. Clearly, the time has come for a new approach.
Before we consider alternatives, we need to know that psychoactive substances are products that when ingested, inhaled, injected or absorbed affect a person’s mental processes. These ‘drugs’ are not necessarily addictive. They include alcohol, tobacco, cannabis, opiates, psychedelic substances and stimulants such as cocaine and amphetamines among others.
For thousands of years we have been using psychoactive substances in spiritual and religious rituals, for medicinal purposes and by significant proportions of populations for individual reasons and as part of social interactions. Among the first known examples are the Sumerians, who in 3400 BC were cultivating the “joy plant” (opium poppies); cannabis has been used medicinally in China since at least 3000 BC.
Today, our societies have been devoting millions of dollars and other resources at stopping the uses of psychoactive substances. It has not worked. There is now ample evidence that an alternative approach can and does work. That is, devising policies and practices based on a public health approach. Evidence-based action addresses underlying determinants of health and makes health promotion and prevention of death, disease and injury at the center of policies and practices.
The Canadian Public Health Association (CPHA) just released a discussion paper calling for discussion on managing the use and abuse of psychoactive substances. Called, “A New Approach to Managing Illegal Psychoactive Substances in Canada,” the report presents an excellent overview of the problems we face and opens up discussion on the subject.
As an independent voice for public health in Canada, the CPHA is also the only Canadian non-governmental organization focused exclusively on public health. It is ideally placed to facilitate discussion on the topic and to provide a framework for action.
In its paper, the CPHA does not identify what actions or policies are required. Rather, it provides sound information about the challenges we face trying to manage these substances in ways that benefit our society — criminalization and prohibition are not the answer.
To learn more about the CPHA and its report, visit them online at http://www.cpha.ca and download the report.
Editor’s note: Dr. Paul Martiquet is the medical health officer for rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.
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