Commentary Controlling illegal stimulants : a regulated market model

Prohibition of illegal drugs is a failed social policy and new models of regulation of these substances are needed. This paper explores a proposal for a post-prohibition, public health based model for the regulation of the most problematic drugs, the smokable and injectable stimulants. The literature on stimulant maintenance is explored. Seven foundational principles are suggested that could support this regulatory model of drug control that would reduce both health and social problems related to illegal stimulants. Some details of this model are examined and the paper concludes that drug policies need to be subject to research and based on evidence. Commentary The global movement toward recognizing the failure of drug prohibition is growing. This is partly due to the emergent understanding that drug prohibition is the dominant driver behind the creation of a illegal market that spawns significant health and social pathologies, harmfully engages our youth, and makes impure illegal drugs widely available. In Canada the concept of a regulated market has been proposed as an alternative to drug prohibition [1-3] and this reflects the growing international movement [4-6]. One of the next steps toward evidence-based drug policies is to develop specific models of drug control for each of the different classifications of drugs. These models should be able to demonstrate that their implementation would produce less harm than the current prohibitionist model. Different types of drugs will need different models of control due to their widely differing pharmacological attributes. The smokeable and injectable stimulants have a wide range of potential harms and therefore pose a considerable challenge to those proposing new, public health based models of drug control. The goal of this paper is to address this challenge and explore a specific model that could be used in a post-prohibition paradigm to reduce the harms caused by these specific substances. This paper will explore some of what is known about the patterns of stimulant drug use and recommend a more optimal policy direction than the current prohibitionist model. The mass media in Canada describe the use of crystal methamphetamine as a plague [7] or epidemic [8] and warns of marijuana laced with crystal methamphetamine even when no contaminated marijuana is seized by the police [9]. Poll reports indicate that the media exaggerate the prevalence of use. In schools, use of crystal methamphetamine is likely very limited, as only 4–5% of students report having ever used this drug [10]. This use was probably not by injection, as reports show that only between 0–1% of students have ever injected drugs [10,11]. Use of cocaine by students is also low, at about 5% [11]. These usage rates are in sharp contrast to marijuana use rates, as over half of British Columbia's 17 year olds report having used this drug [11]. The use patterns of injectable or smokable stimulants are limited to the most marginalized populations, such as street youth, where frequency of use is significant and may be increasing. In the street youth Published: 23 January 2008 Harm Reduction Journal 2008, 5:1 doi:10.1186/1477-7517-5-1 Received: 12 July 2007 Accepted: 23 January 2008 This article is available from: http://www.harmreductionjournal.com/content/5/1/1 © 2008 Haden; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.