Drugs, Health, and Rights: An Exchange
The following exchange consists of e-mails sent yesterday by "Rafaela" of Brazil and me regarding drug prohibition, individual rights, and health policy. --Ari Armstrong, January 7, 2008
Hi Mr Armstrong,
I've recently read an old article of yours, about Dr. Jeffrey Schaler's book "Addiction is a Choice" (http://www.freecolorado.com/2003/10/choice.html), and found many interesting points of view regarding drug use and the prohibition of it, but on a few portions of the article raised some doubts for me.
From what I understood, ultimately you are against drug prohibition, as it is an individual choice from the individual that does not affect others, and even compare today's drug war to an Inquisition of sorts, where people who defend prohibition are mostly driven by a misguided sense of morality.
Now, I don't really have a completely formed opinion on whether drugs should be legalized or not (which is one of the reasons why I enjoyed the opinions in your article). I'm a doctor from Brazil, and the main problem i had with this line of thought is that in my opinion, this is a choice that does affect others. I don't know much about the US medical system, but in Brazil, we have two types of systems: Health Plans (which work exactly like in your country, i'm sure), and the Unified Health System, financiated by the federal and local governments, which provides assistance to the less privileged in all complexities, to simple consults to complex surgeries. Now, wouldn't the increase of substance use bring on a variety of health problems (such as an increase in the incidence of Hep C, HIV and other illnessess not directly related to the use of IV drugs) on these individuals that would ultimately affect the collective health system? I strongly believe in the individual choice, but sometimes the State does interfere in matters of public health in ways that i don't find completely wrong (for example, there's a tropical disease transmitted trough mosquito bites, those were attracted to still waters, there was a strong State campain against reservatoires of stillwater in individuals homes).
Forgive me if I haven't made a lot of sense while writing this, or misunderstood your point, but English isn't my first language, and such mistakes often happen. And I'm also sorry for the length of this.
Thank you very much for your attention,
Ari Armstrong Replies
I'll start with the easiest, most empirical matter first. Would the re-legalization of drugs increase the use of infected needles, and thus increase the number of illnesses? My answer is no: the re-legalization of drugs (and clean needles) would reduce the use of infected needles in favor of clean needles. But there is a broader point: the prohibition of drugs has led to the use of more concentrated drugs, which are often smoked or injected. I believe that, with an end of prohibition, people who use drugs would tend to use them orally more often, which would reduce the number of needles used.
Now for the deeper political issues. It is NOT my view that drugs should be re-legalized because drug use "does not affect others." That is not the correct political standard. Plenty of things that impact others should be outlawed, such as assault, rape, and homicide. Then again, plenty of things that impact others should not be outlawed. For example, if a father eats a poor diet and refuses to exercise, that will impact his children, but diet and exercise should not be matters of law.
The proper political standard is individual rights. We have the right to control our own bodies and resources, provided that we respect the equal rights of others. Quite simply, there is nothing about drug use per se that violates rights. Now, some people who use drugs (including the legal drug alcohol) also commit criminal acts, but they should be punished for those criminal acts, not for the drug use. Obviously, drugs, just like many other objects, can be used responsibly or irresponsibly. The use of marijuana or opiates to ease physical pain can be quite morally proper. Any drug addiction, just like any sort of psychological addiction, is harmful. The proper purpose of government is to protect individual rights, not force people to otherwise behave as they should.
But don't irresponsible behaviors, such as drug abuse, cause more health problems? No doubt. But that is a political problem only under socialized medicine. If socialized medicine justifies drug prohibition (which, by the way, does not eliminate but increases related health problems), then it also justifies diet control, mandatory exercise, the violation of property rights (such as a ban on unhealthy restaurants), censorship, and compelled health education.
As Lin Zinser and Pual Hsieh, MD, write: "A final (and often unacknowledged) consequence of government interference in medicine is that it leads to violations of individual rights in other areas of life, such as violations of the right to free speech and mandates regarding what people may and may not eat. When the government pays our health care bills, in order to save money, it inevitably demands greater control in how we lead our daily lives."
The answer to the problems generated by socialized medicine is not to impose political controls on other parts of our lives, but rather to establish liberty in medicine (as Zinser and Hsieh eloquently argue).
Finally, I would like to address another example you offer in your e-mail. What about people who allow mosquito infestations on their property? As an aside, I am curious: I have often heard the claim that DDT bans have greatly exacerbated the problems of mosquito-born illnesses; do you know if this is the case in Brazil? But on to the example as it stands. A good argument could be made that allowing a mosquito infestation violates the rights of others by subjecting them to dangerous diseases, and thus government intervention of some sort is justified. But I fear that the problem requires the expertise of somebody who knows more about legal theory. Regardless of the legal issues, certainly a voluntary effort to eradicate mosquito infestations and educate people of their dangers would be appropriate. More broadly, what Brazil needs is economic freedom and secure property rights, so that its people can generate the wealth required to solve this and other life-threatening problems.
I hope that my response has been of some interest to you.