Tough love will work better for Filipinos in the War on Drugs

In my last article, I presented an argument against the folly of subscribing to a silver bullet idea that promises to wipe out our country’s drug problem. There have been ideas floated that either or both decriminalization and legalization will solve the drug menace since these have been shown to work in featured western countries like Portugal and America. Proponents of legalization have argued, using lessons learned from the Prohibition era in America that outlawing in-demand mind altering commodities like alcohol will only result in a disastrous failure. Proponents of decriminalization have argued, using the Portuguese model, that health treatment for drug addicts instead of incarceration or other forms of punishment is more effective. This article will attempt to critically assess the claims of the proponents of the western liberal approach and present a case why such may not be compatible in an Asian country like the Philippines.

Legalization: Still not feasible

First of all, the notion that the Prohibition was a failure may not be entirely true. I believe it is important (and fair) to look at the issue on both sides of the fence as well as to look at Prohibition within a defined context. Two prominent scholars from opposing sides come to mind – Harvard Professor Mark Moore (for the anti-legalization size) and Professor Mark Thornton from the Cato Institute (for the pro-legalization side).

Prof. Moore argues that the conventional view of Prohibition is not supported by the facts. He said:

First, the regime created in 1919 by the 18th Amendment and the Volstead Act, which charged the Treasury Department with enforcement of the new restrictions, was far from all-embracing. The amendment prohibited the commercial manufacture and distribution of alcoholic beverages; it did not prohibit use, nor production for one’s own consumption. Moreover, the provisions did not take effect until a year after passage -plenty of time for people to stockpile supplies.

Second, alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkennness and disorderly conduct declined 50 percent between 1916 and 1922. For the population as a whole, the best estimates are that consumption of alcohol declined by 30 percent to 50 percent.

Third, violent crime did not increase dramatically during Prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during Prohibition’s 14 year rule. Organized crime may have become more visible and lurid during Prohibition, but it existed before and after.

Fourth, following the repeal of Prohibition, alcohol consumption increased. Today, alcohol is estimated to be the cause of more than 23,000 motor vehicle deaths and is implicated in more than half of the nation’s 20,000 homicides.

Please note that Moore does not say that Prohibition was a total success or that it even was a good idea. But we should instead take a pause before we jump to conclude that legalization won’t have more consumption or any significant consequences from abuse of consumption.

Thornton’s counter-argument, on the other hand, does not dispute the fact that Prohibition era resulted in a decrease in alcohol consumption but that the decrease was insignificant.

“According to its proponents, all the proposed benefits of Prohibition depended on, or were a function of, reducing the quantity of alcohol consumed. At first glance, the evidence seems to suggest that the quantity consumed did indeed decrease. That would be no surprise to an economist: making a product more difficult to supply will increase its price, and the quantity consumed will be less than it would have been otherwise.”

Moreover, Thornton argues that high enforcement did not stop the increase in consumption as consumption actually rose again in the latter stages of the era.

Thornton may indeed have a point. However, if we are to measure the success of Prohibition by looking at its intent – reduction of alcohol (or liquor) consumption, historical data shows that it actually worked. Huron University College Professor Dr. Jack Blocker even pointed out that there have been numerous beneficial legacies left by Prohibition. Some of these include the following:

“The shortest-lived child of Prohibition actually survived to adulthood. This was the change in drinking patterns that depressed the level of consumption compared with the pre-Prohibition years. Straitened family finances during the Depression of course kept the annual per capita consumption rate low, hovering around 1.5 US gallons. The true results of Prohibition’s success in socializing Americans in temperate habits became apparent during World War II, when the federal government turned a more cordial face toward the liquor industry than it had during World War I, and they became even more evident during the prosperous years that followed. Although annual consumption rose, to about 2 gallons per capita in the 1950s and 2.4 gallons in the 1960s, it did not surpass the pre-Prohibition peak until the early 1970s.

The death rate from liver cirrhosis followed a corresponding pattern. In 1939, 42% of respondents told pollsters that they did not use alcohol at all. If that figure reflected stability in the proportionate size of the non-drinking population since the pre-Prohibition years, and if new cohorts—youths and women—had begun drinking during Prohibition, then the numbers of new drinkers had been offset by Prohibition’s socializing effect. By 1960, the proportion of abstainers had fallen only to 38%.”

Sure, Prohibition was eventually repealed but it was not because of the inelastic demand for alcohol as popular belief dictates. I believe it is valuable to look at this from a historical perspective. Dr. Blocker points out that:

“Because the Volstead Act was drafted only after ratification of the Eighteenth Amendment was completed, neither the congressmen and state legislators who approved submission and ratification, nor the voters who elected them, knew what kind of prohibition they were voting for. The absolutism of the act’s definition of intoxicating liquors made national alcohol prohibition a stringent ban, and the gap between what voters thought they were voting for and what they got made this sweeping interdict appear undemocratic. Nevertheless, support for prohibition in post-ratification state referenda and the boost given to Herbert Hoover’s 1928 campaign by his dry stance indicate continued electoral approval of Prohibition before the stock-market crash of 1929.
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American voters continued to support Prohibition politically even in its stringent form, at least in national politics, until their economy crashed and forcefully turned their concerns in other directions.”

Now can we really use a parallelism of alcohol’s prohibition demise with the merits of legalization of illicit drugs like heroin and shabu? I do not think so. Like I suggested in my previous article, comparing alcohol and drugs may be akin to comparing apples and oranges. Hard drugs like shabu are highly addictive, extremely harmful and mind-altering when abused. Alcohol, although also potentially harmful when abused, has been integrated in people’s lives even before the Prohibition era. We already have it as an acceptable part of human lives and it is here to stay. Syndicated columnist Dr. Charles Krauthammer was correct to say that the problem is “…you never start society from scratch. Alcohol is ingrained in the culture. We learned that in prohibition. You have to regulate it. And my question is, do we really want to add a second intoxicant onto that?” Indeed, Krauthammer makes a great point. Even if we argue that alcohol has the same detrimental effects as drugs, as Krauthammer said:

“The question is not which is worse, alcohol or drugs. The question is, can we accept both legalized alcohol and legalized drugs?”

Sure, legalization proponents may argue that legalization of drugs may take away profits from and diminish the power of criminal syndicates. It may also free up much needed budget to be used for other priorities instead of appropriating for the cost of law enforcement. Heck, it may even reduce corruption! But as Krauthammer pointed out:

“What legalizers minimize is the catastrophic effect that legalization would have on public health, an effect that would far outweigh the savings in law enforcement. We had an inkling of that during Prohibition. Prohibition was a law enforcement disaster but, during its early years at least, a public health triumph. The rates of such alcohol-related illnesses as cirrhosis of the liver and alcoholic psychosis went down remarkably.

Well, you ask, if alcohol is now legal, what is the logic of prohibiting cocaine and heroin? No logic, just history. Alcohol use is so ancient and so universal a practice that it cannot be repealed. The question is not: Which is worse, alcohol or cocaine? The question is: Which is worse, alcohol alone or alcohol plus coke and heroin and PCP? Alcohol is here to stay. To legalize other drugs is to declare that the rest of the pharmacy is here to stay too.

Do we really want the additional and permanent burden of the other intoxicants, some of which are infinitely more addictive than alcohol?”

These illicit drugs just have so many health risks and a lot of them when combined with alcohol may spell bad news for a consumer!

Now with regards to the argument that legalized narcotics would make such products safer for public consumption, I would agree that it probably will. However, I would argue that a legalized shabu may not necessarily be patronized by your typical two-bit Filipino street junkie. I am not familiar with the Philippine FDA drug approval process but in America the whole process of getting a drug developed and approved typically costs billions of dollars and it takes years (a lot of times more than a decade) for it to be available in the market! Just because shabu no longer needs to be “re-discovered” does not mean it doesn’t have to go through the same process and costs. Safety and efficacy need to be established first and manufacturers need to go through the various stages of the approval process (from pre-clinical to the different clinical phases to manufacturing to post-market surveillance). Even if shabu were to be approved the dosage or amount allowed to be packaged and dispensed will not likely be the same as the dosage and amount that the junkies would require to get their fix. The whole point of the drug approval process is to protect the consumer public from drug toxicity so it would be quite insane for a drug like shabu to be approved if the whole point of its use (in the junkie’s perspective) is intoxication! Besides, if a drug manufacturer were to go ahead and pursue such a business venture in getting recreational shabu approved, who do we think will shoulder the cost in the end? It will be the consumers! Which one do we think that a typical deadbeat junkie will patronize? A legally marketed shabu (Desoxyn) that costs, say, around Php10,000 per 100mg or shabu in the black market that costs Php2,000 per “pingi” (100 mg)? (cost estimates are based on assumption that a typical fix requires 100mg of shabu with “pingi” costing Php2,000 and Desoxyn costing around $10 USD per 5mg tablet) Combine this factor with ease of availability. A legalized shabu will most likely be considered as a “controlled drug” hence requiring a doctor’s prescription to be dispensed (with tough restrictions) at government authorized dealers. A black market shabu, on the other hand, can be available at a dark street corner near you.

Portuguese model: unlikely to work for us

The way Portugal has dealt with its drug addiction problem certainly has surprised the world. Many articles have been published in praise of their approach. It has been said that contrary to many doomsday scenarios predicted before their liberal approach was launched, the opposite effect has resulted. Drug use among adults have fallen, the number of HIV cases among drug users declined, even drug overdose deaths are at an all-time low. However, the problem with the Portuguese model is that it really is difficult to conclusively say whether it is the decriminalization of drugs that gave it “success” or the country’s increased access to drug addiction treatment. In this experiment, the two approach (decriminalization and increased treatment) happened at the same time and there was no experimental control involved. In fact, the architect of Portugal’s drug policy himself, Dr. Joao Goulao said:

“It’s very difficult to identify a causal link between decriminalization by itself and the positive tendencies we’ve seen. It’s a total package. The biggest effect has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear.”

Although there have been data released that show positive results, not everything is peachy either. For instance, the EMCDDA reported:

“In 2012, it is verified that the higher continuity rates of consumption are LSD and cannabis, is important, especially in the case of LSD which is the only substance that presents slight increases in the prevalence of use.”

Also from the same report, it appears that school-aged children have been more vulnerable as a result of the decriminalization policy. Between 2010 and 2011, there was an increase in drug use in this population. In light of this result, the Portuguese government stepped up its prevention measures by increasing education efforts in schools.

The points I raised are not meant to diminish the “success” of the Portuguese model. It does appear that the decriminalization policy, treatment and prevention education measures they implemented did, in fact, result in wonders. However, it should be noted that such an approach seems very vulnerable to economics. George Murkin, policy and communications officer of Transform, projects that:

“There is a real risk that Portugal’s severe economic recession will undermine many of the drug-related health and social improvements observed since 2001.

Socioeconomic deprivation is associated with greater levels of drug-related harm and drug dependence, and public spending cuts taken in response to economic crises can exacerbate this situation.

Significant reductions in health and welfare budgets in Portugal have led to fears that the country may experience a dramatic increase in HIV infections, as Greece did when it closed drug treatment and harm reduction programmes as part of its attempts to reduce public spending.

The independent Institute for Drugs and Drug Addiction, which was responsible for implementing the national drug strategy, has effectively been abolished and absorbed by the country’s National Health Service, which in turn has had its budget cut by 10%. A number of harm reduction services are also facing partial closure, or experiencing significant delays in receiving public funding, all of which has had a negative effect on the extent and quality of services provided.

The threat posed by economic recession underscores how crucial adequate health and social investment was in achieving the gains made following decriminalisation. The challenge now for Portugal is ensuring these gains are not lost.”

As my previous article pointed out, we have to be mindful of the many difference between Portugal and the Philippines. Portugal only has roughly 10% of the Philippines’ population and a glaring difference in average income per person (Portugal has $22,900 GDP vs $4,700 GDP). With the Philippines having a much lower tax base than Portugal, can we really expect the Philippine government to be able to sustain the Portuguese model’s infrastructure to support such a measure? If we say that we should invest a big chunk for this crisis then what program are we willing to make budget sacrifices on? Public transportation? Education? Public works and highways? Energy? Defense? With one-fifth of all the barangays in the Philippines (92% of all barangays in Metro Manila) affected by the drug menace I can only imagine the enormous cost the Philippine government would have to face should it wish to replicate the Portuguese model. Bottom-line is: We just cannot afford to baby our drug addicts!

Difference in culture

While policies in Portugal and some States in America (e.g. Washington State and Colorado) may have produced impressive success, it doesn’t necessarily follow that the policies they pursued will work in the Philippines. I can see this problem being similar to how Eastern and Western cultures approach discipline.

Kieu Tran from the University of Colorado at Boulder offers an interesting take on the difference in discipline approach between Asians and Westerners. She tells that:

“In Vietnam, the family structure plays a very important part in society, and means a lot to each individual. With the influence of Confucianism and Buddhist philosophy, the Vietnamese family structure is very unique: the family seems like a little community within a greater community. Both parents and children know how to maintain their own roles and responsibilities in the family. Parents, especially the father, have the ultimate authority or power over the children. They act as supporters to assist their children to fit into the social structure. There is always the hierarchy in the family and between the relationship of parents and children. Parents seem somewhat more serious than friendly and always apply a strict discipline to the children, but are always prepared to give encouragement and advice. When they have to use disciplinary means, they do not hesitate to apply harsh punishments, like striking, without interference from police, relatives, or neighbors. In Vietnam, there are no social workers. Other members of the family, such as grandparents, aunts, uncles, etc. also can punish naughty children. In turn, the obligation of children is to submit, obey, and respect their parents and other relatives. There is no question of hatred between parents and children. Children never talk back because of the strict punishment. They have to accept it when they are wrong or when they make a mistake.
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As I see it, in America, the family structure seems to be unimportant. Discipline in the American family does not seem to be strict because the meaning of the term “everyone is equal” influences American families. Parents and children have equal rights. Children can argue, talk back, and even fight for their own rights. There is no hierarchy in the family system. American parents can play two roles at the same time: parents and friends. There is no way that they can physically punish their children, if their children perform badly. They can only talk about their children’s mistakes and give verbal advice.
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Physical punishment may also mean discipline for the Vietnamese family. Children feel shamed, along with their pain, when they are being punished. Next time, they will remember that, if they do not obey their parents, they will get pain again, so they avoid making mistakes.”

Family structure with an authoritative figure head is very important in Asian cultures like in Vietnam and in the Philippines. On the other hand, Western family structure focuses more on individualism. In Asian cultures, physical punishment by the parents on erring children is part of traditional culture. In addition, respect and obedience to elders is integral.

Filipinos who have lived and been immersed in Western culture may find appeal in Western ways. But for Filipinos living in the Philippines, a benevolent authoritarian way of discipline is ingrained in the culture. Tough love, very similar to alcohol, is so ancient and so universal a practice that it cannot be repealed in our culture. I submit, that being Asians, a more culturally compatible approach will be more effective for Filipinos in the Philippines than that of a Western and liberal approach.

(Top image from yahoo.com)