DEMAND OR HARM REDUCTION

Efforts to reduce demand for illicit drugs include both sanctions and incentives. Sanctions focus on law enforcement initiatives meant to apprehend and deter consumers through fines, jail sentences and loss of privileges. Positive incentives have also been developed to offer people reasons to cease, or at least greatly to reduce, illicit drug use. The combination of sanctions and incentives is meant to create a climate wherein non-users are reluctant to take up the habit. Aside from law enforcement initiatives designed to raise risks for consumers, the demand reduction strategies of principal consuming countries have focused on popular education in the classroom and through the mass media, initiatives in the workplace, civic action, anti-contagion treatment programmes and efforts to develop an anti-drug ethos.

Intensifying the negative component of demand reduction strategies through increased reliance on prohibition, combined with law enforcement efforts that are increasingly tough on users, is likely to be effective only among two types of people: those who have something of value to lose and those who see themselves as having a future worth sacrificing for. Crack cocaine and heroin users who are members of the “underclass” might therefore not be much affected by such strategies.

Initiatives in the workplace to reduce consumption are principally based on drug testing, with threats of dismissal if positive results are returned. This strategy is unlikely to reduce demand for drugs among the burgeoning number of inner city crack users, arguably the greatest problem in the United States, and perhaps elsewhere. This approach presumes that the drug user wants employment and has it, that the employer values the employee and that they both have an incentive to work together to create a drug-free workplace. All these factors are unlikely to coalesce among unskilled, low-skilled or minimum-wage employees, who are usually quickly replaceable and are themselves likely to drift from job to job.

Education is one of the primary elements of the positive component of demand reduction strategies. If education within the classroom is to reduce demand, it needs to be coupled with community-wide integrated efforts, including the dissemination of explicit anti-drug values and peer modelling begun at a fairly early age. The mass media in several consuming nations have had some success in targeting certain audiences for such anti-drug campaigns.

Civic action is also a way to reduce demand for illegal drugs. Helping people to build homes, assisting the long-term unemployed to acquire skills and find jobs, creating educational and other opportunities for children in poor communities are activities in which communities have engaged, and which have had a positive impact on their drug problems. Raising community support for voluntary anti-drug service is a first step, but effective co-ordination is required to ensure that acceptable goals are pursued in productive ways. Some communities are attempting to orchestrate this co-ordination. In Detroit, Michigan, a community in one of the city’s abandoned-house districts has launched an effort to purchase “crack houses”, renovate them and sell them at low cost to senior citizens and single parent families who need housing and can be relied upon not to participate in the drug trade. Other community initiatives include self-help groups for addicts and an anonymous hotline for residents to report drug-related activities in their neighbourhoods without fear that their identity will be revealed.

Another demand reduction strategy involves treatment programmes, which are thought by some to be useful not only for addressing the addiction of individuals, but also for reducing the spread of drug addiction. The assumption underlying treatment as a strategy to reduce consumption is that drug addiction spreads like a contagious disease: most people become drug users and perhaps eventual addicts because friends have introduced them to the practice, pushing drugs to support their own addiction. Therefore, successfully treating addicts removes their economic need to market drugs to acquaintances and eliminates a large partof the reason for the spread of drug addiction. Accordingly, proposals have been made - by law enforcement officers, among others - for considerably more funding for drug addiction treatment programmes.

Finally, efforts have been made to develop an “anti-drug ethos” as a means of reducing demand. One of the strongest deterrents to the use of illicit drugs is people’s conviction that drug use is inappropriate, whether for moral or utilitarian reasons. If the fundamental values of a specific group of people change in ways which disfavour drugs, the reduction in consumption will be more lasting. This kind of value change is more likely to be brought about by persuasion than by coercion. Thus calls are made for the mobilization of community efforts to re-establish eroded social values and to provide substantial social incentives for people to reform their lifestyles.

All direct demand reduction options concentrate on users and assume that illicit drug use may be reduced by approaches that invoke fear, self interest or value change. An indication of drug policy priorities in the United States is given by the allocation of expenditures in the country: 75 per cent of total drug control expenditure goes for repression of consumption and supply, compared to 25 per cent for prevention, education, research and treatment. So far, an emphasis on fear (e.g. fear of jail and of property losses) has formed the basis of consumer-focused demand reduction policies. Not surprisingly, fear strategies work best on those in the middle class whose employment and property are at risk. Such policies have had no proven drug consumption effect on the economic underclass where much hard-core drug abuse takes place.