Decriminalisation and smart regulation of psychoactive substances: a modern alternative to prohibition
Authors:
Viktor Mravčík
Authors place of work:
Společnost Podané ruce, Brno
; Úřad vlády ČR
; Klinika adiktologie 1. LF UK a VFN v Praze
Published in the journal:
Čas. Lék. čes. 2023; 162: 231-237
Category:
Review Article
Summary
Prohibition has been the globally dominant concept for the regulation and control of psychoactive substances for nearly 70 years. Its effectiveness and legitimacy as a sustainable solution to the problems associated with the existence of psychoactive substances in society has been repeatedly questioned. It is based on the normative assumption that the use of psychoactive substances for other than therapeutic purposes is not allowed, and non-medical supply should be severely punished. This precludes the use of the full range of regulatory, public health, prevention, and harm reduction strategies, reduces well-being, and increases harms for the human-rights, health, and social cohesion.
It is time to replace the prohibitionist paradigm with modern regulation that considers the different harms and risks of psychoactive substances, but also the benefits of psychoactive substances for mental health and well-being, lifestyle, and socialisation. This new paradigm (the so-called 'smart regulation') should accept non-medical use of psychoactive substances, apply criminal law as an exceptional tool to regulate human behaviour, regulate the availability of substances according to their harmfulness, regulate the risk profile of the product, strictly regulate marketing and advertising, protect minors and 'others' from the use and supply of psychoactive substances, protect the legal market from the supply of substances from the illegal market, and use economic instruments to regulate demand and to subsidise prevention and treatment.
Keywords:
drug policy, psychoactive substances, addiction, regulation, decriminalization, prohibition
Zdroje
- Hall W. The future of the international drug control system and national drug prohibitions. Addiction 2018; 113: 1210–1223.
- Mravčík V. (De)criminalisation of possession of drugs for personal use – a view from the Czech Republic. Int J Drug Policy 2015; 26: 705–707.
- European Drug Report 2022: Trends and Developments. European Monitoring Centre for Drugs and Drug Addiction, Lisbon, 2022.
- World Drug Report 2023. United Nations Office on Drugs and Crime, New York, 2023.
- Csete J, Kamarulzaman A, Kazatchkine M et al. Public health and international drug policy. Lancet 2016; 387 (10026): 1427–1480.
- Mravčík V, Chomynová P, Grohmannová K. Veřejnozdravotní význam užívání návykových látek. Hygiena 2019; 64: 21–26.
- Rehm J, Anderson P, Fischer B et al. Policy implications of marked reversals of population life expectancy caused by substance use. BMC Medicine 2016; 14: 42.
- Nutt DJ, King LA, Phillips LD. Drug harms in the UK: a multicriteria decision analysis. Lancet 2010; 376 (9752): 1558–1565.
- van Amsterdam J, Opperhuizen A, Koeter M et al. Ranking the harm of alcohol, tobacco and illicit drugs for the individual and the population. Eur Addict Res 2010; 16: 202–207.
- Bonomo Y, Norman A, Biondo S et al. The Australian drug harms ranking study. J Psychopharmacol 2019; 33: 759–768.
- Nutt D, King LA, Saulsbury W et al. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 2007; 369: 1047–1053.
- Lachenmeier DW, Rehm J. Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach. Sci Rep 2015; 5: 8126.
- Decriminalisation of People Who Use Drugs: A Guide for Advocacy. International Drug Policy Consortium, 2022.
- Regulation. The Responsible Control of Drugs. Global Commission on Drug Policy, 2018. Dostupné na: www.globalcommissionondrugs.org/wp-content/uploads/2018/09/ENG-2018_Regulation_Report_WEB-FINAL.pdf
- Jelsma M. UN Common Position on drug policy – Consolidating system-wide coherence. International Drug Policy Consorcium and Transnational Institute, London, 2019.
- Office of the United Nations High Commissioner for Human Rights. Human rights challenges in addressing and countering all aspects of the world drug problem. Human Rights Council, Fifty-fourth session, Agenda item 3, Geneva, 2023 Sep 11 – Oct 6.
- Rodiny proti prohibici. Praha, 2023. Dostupné na: https://rodinyprotiprohibici.cz
- Cole J, Hussar J. Voláme po dekriminalizaci konopí. Charta 420, Praha, 2022. Dostupné na: https://charta420.cz
- Stanovisko k probíhajícím změnám v oblasti dekriminalizace a legální regulace psychoaktivních látek. Společnost pro návykové nemoci ČLS JEP, Vlachovice, 15. 5. 2023.
- Adams JM, Volkow ND. Ethical imperatives to overcome stigma against people with substance use disorders. AMA J Ethics 2020; 22: E702–E708.
- Wogen J, Restrepo MT. Human rights, stigma, and substance use. Health Hum Rights 2020; 22: 51–60.
- Mravčík V, Chomynová P, Grohmannová K. Koncept problémového užívání návykových látek. Psychiatrie 2019; 23: 121–128.
- Ritter A. Illicit drugs policy through the lens of regulation. Int J Drug Policy 2010; 21: 265–270.
- MacCoun R. The implicit rules of evidence-based policy analysis, updated. Addiction 2010; 105: 1335–1336.
- Malinowska-Sempruch K, Lohman D. From drug prohibition to regulation: a public health imperative. Lancet 2022; 400: 645–646.
- Tyndall M, Dodd Z. How structural violence, prohibition, and stigma have paralyzed north american responses to opioid overdose. AMA J Ethics 2020; 22: E723–728.
- Piquero AR, Paternoster R, Pogarsky G et al. Elaborating the individual difference component in deterrence theory. Annu Rev Law Soc Sci 2011; 7: 335–360.
- Guan X, Lo TW. Restrictive deterrence in drug offenses: a systematic review and meta-synthesis of mixed studies. Front Psychol 2021;12: 727142.
- Hughes B, Matias J, Griffiths P. Inconsistencies in the assumptions linking punitive sanctions and use of cannabis and new psychoactive substances in Europe. Addiction 2018; 113: 2155–2157.
- Stevens A. Is policy 'liberalization' associated with higher odds of adolescent cannabis use? A re-analysis of data from 38 countries. Int J Drug Policy 2019; 66: 94–99.
- Benedetti E, Resce G, Brunori P et al. Cannabis policy changes and adolescent cannabis use: evidence from Europe. Int J Environ Res Public Health 2021; 18: 5174.
- Zábranský T, Miovský M, Gajdošíková H a kol. Ekonomické náklady společnosti na zneužívání nelegálních („pouličních“) drog v České republice 1998. Adiktologie 2001; 1 (1 – suppl.): 143–189.
- Červený J, Chomynová P, Mravčík V et al. Cannabis decriminalization and the age of onset of cannabis use. Int J Drug Policy 2017; 43: 122–129.
- Muscat R, van de Mheen D, Barendregt C et al. Towards an integrated policy on psychoactive substances: a theoretical and empirical analysis. Council of Europe, Strasbourg, 2010.
- Rehm J, Lachenmeier DW, Room R. Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks? BMC Medicine 2014; 12: 189.
- Bewley-Taylor D, Blickman T, Jelsma M. The Rise and Decline of Cannabis Prohibition: the history of cannabis in the UN drug control system and options for reform. Transnational Institute and Global Drug Policy Observatory, Amsterdam/Swansea, 2014.
- Lancaster K, Ritter A. Examining the construction and representation of drugs as a policy problem in Australia’s National Drug Strategy documents 1985–2010. Int J Drug Policy 2014; 25: 81–87.
- Ritter A. The utility of different values frameworks for drug policy analysis. Addictions – European Conference on Addictive Behaviours and Dependencies, Lisbon, 2022 Nov 2.
- Starr C. Social benefit versus technological risk. Science 1969; 165: 1232–1238.
- Caulkins JP, Kilmer B, Kleiman MAR et al. Options and Issues Regarding Marijuana Legalization. RAND Corporation, Santa Monica, 2015.
- West R. Models of addiction (EMCDDA insights No 14). European Monitoring Centre for Drugs and Drug Addiction, Lisbon, 2013.
- Baumeister RF, Vonasch AJ. Uses of self-regulation to facilitate and restrain addictive behavior. Addict Behav 2015; 44: 3–8.
- Rehm J, Marmet S, Anderson P et al. Defining substance use disorders: do we really need more than heavy use? Alcohol Alcohol 2013; 48: 633–640.
- Rehm J, Shield KD, Gmel G et al. Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union. Eur Neuropsychopharmacol 2013; 23: 89–97.
- Chomynová P, Grohmannová K, Dvořáková Z a kol. Zpráva o nelegálních drogách v České republice 2022. Úřad vlády ČR, Praha, 2022.
- Rosenkranz M, O'Donnell A, Martens MS et al. Individual, social, and environmental factors associated with different patterns of stimulant use: a cross-sectional study from five European countries. Eur Addict Res 2023; 29: 182–193.
- Blum K, Braverman ER, Holder JM et al. Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. J Psychoactive Drugs 2000; 32 (Suppl.): i–iv, 1–112.
- Martens MS, Zurhold H, Rosenkranz M et al. Using life course charts to assess and compare trajectories of amphetamine type stimulant consumption in different user groups: a cross-sectional study. Harm Reduct J 2020; 17: 8.
- Rhodes T, Lilly R, Fernández C et al. Risk factors associated with drug use: the importance of 'risk environment'. Drugs Educ Prev Policy 2003; 10: 303–329.
- Máté G. Beyond Drugs: The Universal Experience of Addiction. 2022. Dostupné na: https://drgabormate.com/opioids-universal-experience-addiction
- Jelsma M. Cannabis regulation vs international and EU law: Legal tensions and compliance options. Wiener Zeitschrift für Suchttherapie, 2022; 3/4.
- Riboulet-Zemouli K, Jeanroy B-A. EU Presidency Policy Brief: Treaty Compliance Options for Cannabis Regulations in the EU (Models of decriminalisation and legal regulation compliant with International Law and EU Acquis). 2023.
- van Kempen PH, Fedorova M. Cannabis Regulation Through the "Without Right" Clause in Article 2(1) of EU Framework Decision 2004/757/jha on Illicit Drug Trafficking. Eur J Crime Criminal Law Criminal Just 2023: 1–29.
- Mravčík V, Grohmannová K, Běláčková V a kol. Nové psychoaktivní látky a jejich výskyt v ČR. Časopis lékařů českých 2015; 154: 216–221.
- Grohmannová K, Mravčík V. Nové psychoaktivní látky v Evropě a ČR. Psychiatrie pro praxi 2018; 19: 96–100.
- Peacock A, Bruno R, Gisev N et al. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet 2019; 394: 1668–1684.
- Reuter P, Pardo B. Can new psychoactive substances be regulated effectively? An assessment of the British Psychoactive Substances Bill. Addiction 2017; 112: 25–31.
- Stevens A, Measham F. The 'drug policy ratchet': why do sanctions for new psychoactive drugs typically only go up? Addiction 2014; 109: 1226–1232.
- Hughes B, Winstock AR. Controlling new drugs under marketing regulations. Addiction 2012; 107: 1894–1899.
- Wilkins C. A critical first assessment of the new pre-market approval regime for new psychoactive substances (NPS) in New Zealand. Addiction 2014; 109: 1580–1586.
- Nekola M, Morávek J. Regulating new psychoactive substances in the Czech Republic: policy analysis under urgency. J Comp Policy Anal Res Pract 2015; 17: 229–246.
- Neicun J, Roman-Urrestarazu A, Czabanowska K. Legal responses to novel psychoactive substances implemented by ten European countries: an analysis from legal epidemiology. Emerg Trends Drugs Addict Health 2022; 2: 100044.
- Seddon T. Drug policy and global regulatory capitalism: the case of new psychoactive substances (NPS). Int J Drug Policy 2014; 25: 1019–1024.
- Hughes B, Griffiths P. Regulatory approaches to new psychoactive substances (NPS) in the European Union. Addiction 2014; 109: 1591–1593.
- Belackova V, Rychert M, Wilkins C et al. Cannabis social clubs in contemporary legalization reforms: talking consumption sites and social justice. Clin Ther 2023; 45: 551–559.
- Tyndall M. A safer drug supply: a pragmatic and ethical response to the overdose crisis. CMAJ 2020; 192: E986.
- Kilmer B, Pardo B. Clarifying 'safer supply' to enrich policy discussions. Addiction 2023; 118: 994–997.
- Transform Drug Policy Foundation. How to regulate Cannabis: A practical guide. Transform Drug Policy Foundation, Bristol, 2013.
- Alice RAP Policy Paper Series. Policy Brief 5: Cannabis – from prohibition to regulation. "When the music changes so does the dance". Alice RAP, 2014.
- Zábranský T, Langer I, Gronský L a kol. Racionální protidrogová politika. Votobia, Olomouc, 1997.
- Anderson P, Braddick F, Conrod P et al. The New Governance of Addictive Substances and Behaviours. Oxford University Press, 2017.
- Reuter P, Trautmann F. A report on Global Illicit Drugs Markets 1998–2007. European Commission, Trimbos Institute, RAND, 2009.
- Vláda ČR. Programové prohlášení vlády Petra Fialy ze dne 6. ledna 2022 a upravené dne 1. března 2023. Úřad vlády ČR, Praha, 2022.
- Sekretariát Rady vlády pro koordinaci protidrogové politiky. Národní strategie prevence a snižování škod spojených se závislostním chováním 2019–2027. Úřad vlády ČR, Praha, 2019.
- Vláda ČR. Akční plán politiky v oblasti závislostí 2023–2025 schválený vládou ČR dne 5. dubna 2023 usnesením č. 230. Úřad vlády ČR, Praha, 2023.
- Zeman P, Pešková M, Roubalová M. Postih provozovatelů growshopů v ČR, závěrečná zpráva z výzkumného úkolu. Kriminologická analýza pravomocných soudních rozhodnutí v trestních věcech souvisejících s prodejem technologií a potřeb pro pěstování rostlin pod umělým osvětlením, tzv. growshopů. Institut pro kriminologii a sociální prevenci, Praha, 2019.
- Mandík J. Trestná činnost související se zneužíváním návykových látek. PrF UK, Praha, 2015.
- Dleštíková T. Co je a co není šíření toxikomanie? Otázka za milion dolarů. Blog. Aktuálně.cz, 18. 2. 2022. Dostupné na: https://blog.aktualne.cz/blogy/ondrej-kysely.php?itemid=41996
- Zeman P. „Výroba“ konopí z konopí? Trestněprávní revue 2015; 9: 211–215.
- Snížení vězeňské populace: jednoduché změny s velkým dopadem uskutečnitelné do 2 let. Asociace organizací v oblasti vězeňství, Praha, 2022.
- Stanovisko MV a Policie ČR k testování tablet extáze na taneční scéně. Ministerstvo vnitra ČR, 2010. Dostupné na: www.mvcr.cz/clanek/stanovisko-mv-a-policie-cr-k-testovani-tablet-extaze-na-tanecni-scene.aspx
- Policejní prezident ČR. Úřední dopis ze dne 14. března 2023, č. j. PPR-24102-25/ČJ-2022-990100-SA. Policejní prezidium ČR, Praha, 2023.
- World Drug Report 2022. Drug market trends: cannabis, opioids. United Nations Office on Drugs and Crime, New York, 2022.
- Běláčková V, Petruželka B, Čihák J a kol. Regulace trhu s konopím – dopadová studie. Jana Michailidu, Praha, 2022.
- Manthey J, Hayer T, Jacobsen B et al. Effects of Legalizing Cannabis. Institut für interdisziplinäre Sucht- und Drogenforschung, Hamburg, 2023.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
Journal of Czech Physicians
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
Najčítanejšie v tomto čísle
- Optimizing nutrition for the treatment of lipedema: new pathways to improved quality of life
- Recommended diagnostic and therapeutic procedures for psychosomatic care
- Decriminalisation and smart regulation of psychoactive substances: a modern alternative to prohibition
- Influence of nutritional intervention combined with vitamin D on the development of sarcopenia