Commentary by Carl Hintz
Many people support the legalization of marijuana, and few people believe that tobacco, alcohol, or caffeine should be illegal. However, “hard drugs” such as cocaine, methamphetamine, and opioids should also be legal without a prescription. My perspective comes from the framework of risk mitigation, the value of freedom, and the belief in compassion. The illegality of drug production, sale, and use only serves to fill prisons and fund organized crime. The legalization of hard drugs for production and sale by a state-owned monopoly could fund public health programs and prevent overdose and poisoning deaths.
Contaminated drugs are responsible for many drug deaths.
According to the Centers for Disease Control (CDC), drug overdose deaths claimed the lives of more than 107,000 people in the US in 2021. According to the NC Department of Health and Human Services, more than 4,000 people were killed by drug overdoses in North Carolina in 2021.
Legalization would prevent overdose deaths such as those caused by drugs that are laced or contaminated, as is often the case with fentanyl and synthetic opioids. In 2021, 3,163 deceased persons in NC tested positive for fentanyl. This does not indicate the exact percentage of deaths caused by fentanyl. In about 20 percent of cases only fentanyl was present, and in the remaining 80 percent other drugs were present such as cocaine, methamphetamine, benzodiazepines, gabapentin, pregabalin, alcohol, and opioids.
Drug prohibition makes even relatively safe drugs deadly.
Multiple entirely preventable deaths and hospitalizations resulted from THC vape pens. The culprit was not the drug itself but the oil that contained Vitamin E causing dangerous lung inflammation. The 2018 Farm Bill legalized hemp products which are regulated by the Food and Drug Administration (FDA). Legalizing THC products derived from hemp while criminalizing marijuana is a convoluted policy, but at least now the FDA can ensure some level of quality control.
A historical example of how prohibition makes drugs more dangerous is the case of methanol poisoning from contaminated alcohol from 1920 to 1933 in the US. A more general explanation is the “iron law of drug prohibition” which argues that the more intense the law enforcement against drugs the more potent drugs will become. This is because it is easier to traffic drugs where a small amount is worth a large amount of money.
Legalized drugs will still be dangerous.
Alcohol is still dangerous. Each year many people die from alcohol poisoning as well as from complications from long term use such as liver failure. The CDC factsheet on alcohol says that alcohol contributes to accidental and self-inflicted deaths and that alcohol even contributes to sexual violence and to homicide. The legality of alcohol does not mean alcohol use is safe. Despite the many harms associated with alcohol, few people today argue alcohol should be illegal.
The use of hard drugs will still be risky even if they are made legal. The same principle that applies to alcohol applies to other drugs—small amounts may be relatively harmless and larger amounts can be deadly. Additionally, an individual can not predict whether he or she will fall into addiction.
What if hard drugs were legal in the US and in North Carolina?
The FDA would be tasked with testing and labeling these drugs. This would help to end the tragedy of drug overdose deaths from contaminated and laced drugs. Drug use would still be risky, but at least drugs would be clearly labeled with warning and dosage information. Drug users would know the exact chemical and the precise amount consumed considerably lowering the risk of an overdose.
Companies should not be allowed to profit from addiction.
Hard drugs could be produced by private companies, but this would create dangerous economic incentives to promote drug use of highly addictive substances. For example, pharmaceutical companies pushed painkillers knowingly and willfully causing the opioid epidemic while profiting royally. Tobacco companies lied about the risks of lung cancer and stroke and targeted young people with flavored vapes. Advertisements for alcohol promote an unhealthy drinking culture such as binge drinking and our society affords few places to socialize that do not involve alcohol consumption.
Instead of private companies profiteering off of addiction, imagine a nationalized or state-owned pharmaceutical industry that also produces hard drugs. Just as the NC economy has been boosted by the legalization of hemp, and will be by the legalization of marijuana, it could also see gains from these government contracts to produce drugs that are currently illegal.
ABC liquor stores could be part of the solution.
North Carolina is uniquely situated to implement drug legalization in an orderly manner. Alcoholic Beverage Control (ABC) stores could oversee the sale of drugs which could be legally purchased by anyone over 21.
The profits from state-owned ABC Liquor Stores should be used for several specific purposes—operational costs; drug addiction treatment and drug use prevention programs; and mental health and public health programs. In this way if society experienced an increase in drug use, the increased revenue would help to address the very real health and social problems relating to drug addiction. Contrast this with the current arrangement in which drug use funds organized crime such as drug cartels that use violence as a business strategy.
It may be beneficial to restrict the sale of currently legal drugs. Limiting sales of soft drugs to ABC stores and licensed bars would address the problem of unscrupulous convenience stores and lenient gas stations selling alcohol, nicotine, and THC products to minors and young adults under 21. Expanding the state’s monopoly so that cigarettes, alcohol, and THC products are only sold by ABC stores and licensed bars would help to increase revenue which could be used for public health measures.
Legalization must be paired with public health.
With a steady funding stream to address public health, much could be gained. The availability of free needles and sharps containers would help to mitigate the spread of HIV and Hepatitis C among injection drug users. Since drug users would often go to ABC stores and safe use sites, these locations would be a natural location to offer resources for overcoming drug addiction provided by social workers. However, addiction treatment programs should be voluntary, not compulsory.
Drug use is not always pathological.
The discovery of medicines that help to treat alcohol and opioid addiction are worth celebrating, but for many people these lifesaving medicines remain out of reach. An even larger cultural shift is needed. Drug use is not always pathological. People should be allowed to take risks and people should be allowed to have mind-altering experiences. Seeking pleasure or escape, even through drugs, should not be a crime.
Backlash can be expected.
Drug use around ABC stores would likely increase, causing consternation of the neighbors and pushback against the legalization policy. To remedy this, safe drug use sites should be established near ABC stores. These safe drug use sites would allow people to use drugs in peace without disturbing the neighbors, thus maintaining the safe feeling of a neighborhood. Society would also be safer both in terms of fewer drug deaths and in terms of less money funding organized crime. Safe drug use sites mitigate the risk of drug overdoses by having medical staff and Narcan on hand. Even before drugs are legalized, activists should push for safe drug sites because they will save lives.
For drug users who prefer more of a partying or social atmosphere, drug use would also be permitted in licensed bars. Adopting distinctions similar to those used in Amsterdam and Denver, licensed bars would be able to sell “soft drugs” such as marijuana and psilocybin mushrooms.
Advertising drugs should be banned.
The commercial advertising of all drugs including cigarettes, alcohol and marijuana should be banned, and replaced with public health promoting PSAs and warning messages. The reason behind this ban on advertising drugs is that society should discourage the use of drugs in the interest of promoting public health. Or, if you hold a more positive view of drugs, the drugs advertise themselves and so advertising is not needed.
Is this a pipe dream?
How could legalization happen without being overtaken by companies hoping to profit such as tobacco companies that would love for marijuana to be legal? Right now the legalization of drugs on the terms of working people might seem distant and out of reach. This radical change could be achieved by a coalition of different social movements. The movements to end mass incarceration, to combat corporate power, to achieve public healthcare such as Medicare For All, to hold tobacco and pharmaceutical companies accountable, to stop violence—each of these social movements may find cause to support the legalization of hard drugs.
Although there is currently no country where hard drugs are legal, both Portugal and British Columbia are notable for decriminalization. After drug decriminalization Portugal saw “encouraging results”—drug use stayed low, blood-borne infections dropped, and between 2002 and 2007 very few drug users were sentenced to prison for drug use or for drug possession. Decriminalization started in the province of British Columbia on January 31st 2023 and is scheduled to continue through January 31st 2026. Adults 18 and older will not be arrested or charged for possession of 2.5 grams total of opioids, cocaine, methamphetamine, or ecstasy.
Short of official legalization or decriminalization, activist citizens could impede drug convictions by refusing to return a guilty verdict if selected for jury duty in a drug trial.
Harm reduction need not wait.
The positive results in Portugal may be attributed not only to the decriminalization law but also to successful harm reduction programs. Many successful programs to help drug users who lived on the margins of society were the effort of civil society and nonprofits without government approval that started before the 2000 decriminalization law. A local example of a harm mitigation effort is the distribution of Narcan, a nasal spray that treats opioid overdoses.
Activists can push for harm reduction programs such as clean needles, chemical testing of illegal drugs, safe drug use sites, methadone clinics, the distribution of Narcan, the funding for public health programs, addiction treatment programs, and a “housing first” approach. Political support for decriminalization and harm reduction policies may come from unexpected places, given the severity of the opioid crisis.
Social movements are a proven path to change.
Political reform will only be achieved if activists form strong organizations and force the issue using direct nonviolent action campaigns. Applying Bill Moyer’s eight-stage framework of social movements, we are past stage two (proving the failure of institutions) and well into stage three (ripening conditions), and at the beginning of stage four (movement take-off). Our task will be to persuade a majority of people not just that change is needed, but also that drug legalization is a viable solution that need not be feared. A strong public health program and improved social safety net could achieve what criminalization can not—treating drug addiction, mitigating the risks associated with drug use, and saving lives.
Carl Hintz is a contributing editor at Triangle Free Press. They teach high school science in Wake Co., N.C.