Policies and measures that impact on the harm done by addictive substances


The harms that drugs can produce to both individuals and society have been known since ancient times. Because of this, societies have developed a range of initiatives and controls to minimize or reduce these harms, sometimes very efficiently, sometimes with no effect, or even with counterproductive effects. In historical societies, controls were enforced through tradition and peer pressure, while in modern societies action is taken through legislative initiatives and the development of health and social policies to address drug-related problems and try to minimize them (Hellman et al., 2016).

One of the cornerstones of democracy is that laws and policies are launched for the benefit of citizens, but quite often relevant pressure groups are able to lobby in order to promote laws and policies that favour their interests, despite having a negative impact on the population. Unfortunately, this happens in all economical sectors, and addictive products are no exception (Miller et al., 2016).

The need for evidence-based policies is an increasing demand from societies, and the public health field has been a pioneer in this request. Nevertheless, it is quite common to see useless policies remaining unchanged, while other policies with a good evidence base may take a long time to implement. In this chapter we make a critical review of drug policies, focusing on those that have proven effective, and exploring ways in which this effectiveness can be increased.

We take the view that humans have always lived and will continue to live with drugs, and this is why a rational approach to the problem needs to take into account the four areas addressed in this chapter: (1) how legal drugs can be modulated in a free market economy as they are not an ordinary commodity; (2) what the different strategies are that empower citizens to resist or moderate the use of addictive products; (3) what the harm-reduction strategies are that effectively reduce the negative impact of addictive products; and (4) how other policies (outside of direct drug control) may have an impact on the use of drugs and health. Finally, we review the impact global treaties on drugs have had until now and the implications for the future governance of addictions (see Box 6.1).

Box 6.1 Key elements of a rational drug policy

Humans have always lived with drugs, and this is why a rational drug policy needs to take into account four key aspects: (1) effective regulation of legal drugs in a free market; (2) strategies that empower citizens to resist or moderate the use of addictive products; (3) harm-reduction strategies that reduce the negative effect of addictive products; and (4) policies (outside of direct drug control) that have an impact on the use of drugs and well-being.

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