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Drug Legalization, Harm Reduction, and Drug Policy
- Don C. Des Jarlais, PhD;
- Samuel R. Friedman, PhD; and
- Denise Paone, EdD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
In their recent article [1], Dupont and Voth characterize harm reduction as “a creative renaming” of the “dismantling of legal restrictions against the use and sale of drugs.” This is a fundamental misconception of harm reduction as we understand it [2-4]. Indeed, within the harm-reduction perspective, “civil and criminal laws are seen as potent tools” [4] for reducing drug-related harm.
DuPont and Voth apparently view drug policy as a dichotomous choice between “two opposing policy options”: prohibition and legalization. In our understanding of harm reduction, the intellectual power of the concept comes precisely from its potential to transcend the old “legalization versus prohibition” debate [3]. Consider the following prototypes of harm-reduction programs:
1) Providing many easily accessible treatment programs for persons dependent on psychoactive drugs [both legal and prohibited]; 2) providing syringe-exchange programs for injection drug users at risk for infection with the human immunodeficiency virus and other blood-borne pathogens (note that syringe-exchange programs have not led to increased drug use and have been found to reduce transmission of blood-borne viruses [[5]]; 3) providing “designated driver” and “call a taxicab” programs to reduce drunken driving; and 4) restricting advertising for, and banning vending machine sales of, cigarettes. None of these programs should be considered as requiring either full legalization or full prohibition of the drugs in question.
We invite readers to take the following short test: Can you think of several new programs, new public policies, new laws, or new social customs that might reduce drug-related harms—without resorting to the old forced choice between legalization versus prohibition? If you can, then you can understand the fundamentals of harm reduction and of contributing constructively to this new paradigm.
Don C. Des Jarlais, PhD
Samuel R. Friedman, PhD
Denise Paone, EdD
Beth Israel Medical Center
New York, NY 10003
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
