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The debate about harmfulness of drugs of abuse in general and cannabis (marijuana) in particular continues to exhibit all the fervour of religious dissent on both sides of the Atlantic. Recently President Obama was moved to opine that marijuana is ‘no more dangerous than alcohol’ (So that clears things up, then). Soon after, US Deputy Drug Tsar Michael Botticelli, in front of a House Committee, found himself struck out by Congressman Gerry Connolly, who pitched him countless examples of drugs that had killed more than marijuana ever had. But Botticelli should have recognised Connolly was giving him the curve ball; death is not and never was the sole criterion of drug harm. This is a cynical misrepresentation frequently pitched by pot advocates. They might protest that they are only searchers of the truth, and that the truth is cannabis never killed anyone. This is actually being economical with said truth; what they mean is that no one ever died of toxic ingestion of the substance, and this is extended to imply that cannabis is jolly safe stuff.

The fundamental dishonesty in all this is that drug use spifflicates people in all sorts of ways (and not just to the user themselves — see below) and to argue otherwise is specious in the extreme. The rational basis for comparing harms, either between one drug and another, or between using any drug and abstaining from it, has to be much wider than ‘death resulted’ — and yet there seems to a reluctance amongst the medical profession to engage to any significant extent. Anyone working with drug users should know there are many varieties of harm, other than death. One basis for defining and assessing harms is the WHO definition of Health, listed below. (The augmentations in brackets are this writer’s own, but in counselling sessions over more than 25 years have been found to be valid by clients). From this basis, ‘Health’ may be defined in terms of: – Physical (all degrees of physical damage, temporary or permanent, including but certainly not confined to death) – Mental (in two parts — how many of your brain cells have survived, and how well do you use the brain cells that you have) – Psychological (how ‘grounded’ or ‘messed up’ are you) – Spiritual (including but not confined to organised religion) – Social (how well do you inter-act with, or variously damage people and organisations around you) and – Societal (to what extent are you a ‘giver’ or a ‘taker’) Marijuana harms by this more rational definition can often equal , and arguably exceed the harms from other drugs.

Moreover, there is a further whole range of harms under these headings – the harms suffered by other people around the user — up to and including society as a whole. As any counselling of these others will show you, it can often be that people around the user (e.g. friends, family, colleagues) suffer more than the user themselves. For example, under the heading of ‘Societal’, death will certainly appear – deaths of other people caused by a pot-impaired driver. Another, often overlooked societal harm is the increase in crime by a user — not just the acquisitive crime to fund drug purchase, but also the crime committed downstream of regular use and which flows from the altered, more self-focused, rapid-gratification-driven attitude of the user.

Additionally, there continues to be an extensive advocacy of ‘The Two HRs’ in relation to drug misuse — Harm Reduction and Human Rights. Whilst both aspects have a valid place in our thinking, both, as applied, are almost totally ‘user-focused’ — confined to the harm and rights of the user, but saying nothing about the harm to and rights of the rest of humanity. This goes to the roots of this commentary.

The foundation of pro-drug argument is the ‘self’. Use of drugs, and consequences of drug use, are argued in terms of self. In contrast, any assessment of drug use in general and drug harm in particular which takes account of the true varieties of harm and the true range and numbers of ‘victims’ just blows pro-drugs pleading of ‘relative harmlessness’ away. It has about as much validity as the tendentious categorising of drug users as ‘otherwise law-abiding’ … in what other category of law-breaking would we countenance such dodgy footwork? Would we for example define burglars or rapists as ‘otherwise law-abiding? And whilst one can sympathise a little with an addicted user who takes this standpoint, there can only be less sympathy for users who are anything less than addicted, and no sympathy at all for the smooth-tongued advocates who make a living out of this scene. Balance is clearly called for on all the aspects covered in this note, but a greater degree of involvement by the medical profession – and the rest of us – in defining and disseminating the full range of drug harms — what they are, and to whom they apply – is long overdue.

Peter Stoker C. Eng. Director, National Drug Prevention Alliance.

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