Richard Seymour finds a provocative but strident case for a socially authoritarian approach to drug use that is unlikely to be convincing to anyone but the converted, in Neil McKeganey‘s controversial title.
Controversies in Drugs Policy and Practice. By Neil McKeganey. Palgrave Macmillan. December 2010.
Professor McKeganey is the ideal guide to the controversies of drug policy, as he has himself been at the centre of several of them. From his Centre for Drug Misuse Research at the University of Glasgow, he has lobbed rhetorical bombshells with vim: “Pay addicts not to have children”, one headline read. “Put CCTV in addicts’ homes to protect children”, read another. The rationale for such interventions is laid excruciatingly bare here. Illegal drug use, McKeganey avers, is a problem as large as global warming, and the only solution is universal abstinence enforced by law.
The scale of the problem, as McKeganey sees it, is outlined with choice statistics from the annual report of the European Monitoring Centre for Drugs and Drug Addiction. In seven European countries, between 10 per cent and 23 per cent of deaths among 15 to 49 year olds are estimated to be caused by drugs. Hepatitis C infections among drug users range from a low of 18 per cent to a high of 95 per cent. HIV infections average at 4.7 cases per million, but are as high as 58.7 per million in some countries.
But whether through choice or default, McKeganey seems to misinterpret the statistics in an alarmist way. Checking the figure for mortality rates in seven European countries, for instance, I find that this applies only to seven European urban areas. In general, there is an interesting tension between McKeganey’s rhetorical escalation of the drug threat here, and his later argument, in the context of supporting prohibition, that the scale of drug use affects only a “small proportion of the adult population”.
The drug problem, as the author sees it, is not one that we must adapt to. This is particularly important for the author’s argument, as the ‘harm reduction’ strategies which he opposes often shade into an acceptance of illegal drug use as a fact which must be worked around, rather than challenged head on. The burden of his criticism of such strategies is partially that they shade into legalisation by the back door. There is a compelling case here that ‘harm reduction’ logically entails drug law reform, which raises political and moral questions that the language of harm reduction was intended to sidestep. However, McKeganey does not mention the alternative criticism, which is that ‘harm reduction’ strategies prop up prohibitionist regimes by mitigating their otherwise dire effects.
The other basis for his criticism of ‘harm reduction’ strategies is that the benefits are limited, inconclusive, and tend not to lead toward an end to drug dependency. The case is weaker here, because even McKeganey has to acknowledge that ‘harm reduction’ strategies have had a major effect in curbing the spread of HIV infection, while the prescription of methadone has reduced the use of illicit opioids and reduced deaths. He deals with this by pointing out that the overall picture, for example the number of drug deaths year on year, has continued to worsen, and thus ‘harm reduction’ is not solving the problem. While this may be true, it is at least mitigating the effects of drug use in significant ways.
Another objection to ‘harm reduction’, which also applies to ‘legalization’ approaches, is that they place drug use in a ‘moral vacuum’. Drug use is neither good nor bad, merely associated with different levels of harm. McKeganey argues that illegal drug use causes sufficient social harm to merit moral disapprobation. Unfortunately, this glancing treatment of a complex moral argument is typical of McKeganey’s approach. The final chapter contains the only sustained discussion of the underlying moral position which motivates the book. Inter much alia, it boils down to a ‘love the sinner, hate the sin’ position. The drug user may not be immoral, but illegal drug use is on account of the harm that it does to society.
But this is a ‘black hole’ morality that collapses distinctions. Not all illegal drug use does obvious harm to society. To take his own example, having conceded that the individual harm resulting from cannabis use is limited, he has difficulty in demonstrating social harm. Furthermore, some of the harms that do occur as a by-product of drug use result from the prohibition strategy which McKeganey supports, a point which he tacitly acknowledges. McKeganey also has relatively little to say about any claim to personal autonomy and dignity on the part of a drug user – a prominent plank in any abolitionist’s case.
Finally, the book wholly neglects social factors potentially contributing to drug use. The sole treatment of this topic is a cursory review of ‘normalization’ of drug use among certain cohorts since the Sixties. There is no mention of poverty, unemployment, or any of the possible circumstances that could make drug use seem appealing. For a book that is concerned with the morality and social aspects of drug use, this is an astonishing omission. What emerges, then, is a provocative but strident case for a socially authoritarian approach to drug use that is unlikely to be convincing to anyone but the converted.
Richard Seymour is a PhD student of sociology at the LSE.