The failure of prohibition as a drug control strategy: the case of AIDS.
Int Conf AIDS 1996 Jul 7-12; 11:2 (abstract no. Mo.05) Drucker E; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA. Fax: 718-798-6378. E-mail: drucker@aecom.yu.edu.
Illicit drug use and addiction are now the single most dynamic feature of the global AIDS epidemic, capable of igniting explosive regional spread of HIV infection: In southeast Asia, over 1 million new HIV infections have occurred in the past decade. The failure to effectively regulate addictive drugs through prohibition policies appears to accelerate this process by creating a vast and profitable criminal economy which drives the rapid expansion of international drug markets - since 1980 worldwide heroin and cocaine production have tripled, with comparable increases in the prevalence of injection drug use and addiction. Independently, prohibition policies and practices increase individual and public health risk by stigmatizing and marginalizing the drug user, further isolating him from AIDS prevention and treatment services. The necessarily clandestine life of the criminal addict fosters several specific patterns of behaviors known to increase HIV transmission e.g. sharing of injection equipment and prostitution. Prohibition drug policies also inhibit the development and utilization of alternative drug control strategies based on public health principals e.g. needle exchange and low-threshold treatment programs. Thus, despite clinical medicine's continued inability to cure AIDS or addiction, these low cost "arm reduction" approaches have proven effective in stopping the spread of AIDS in several nations (Australia, Nepal) and slowing it in others (Thailand and Great Britain). But some countries continue to resist harm reduction because (they say) it contradicts prohibition ideology (e.g. the USA bans the use of federal funds for needle and syringe exchange.) Finally, enforcing drug prohibition by criminalizing the addict inevitably means an assault on basic human rights and individual dignity. In systematic violation of the UN Declaration on Human Rights, national programs of massive prosecution and incarceration of addicts destabilize those communities most vulnerable to drugs and do damage to many social and civic institutions vital to order and public health.
Keywords: AEGIS, Drug and Narcotic Control, Acquired Immunodeficiency Syndrome, HIV Infections, Substance-Related Disorders, Hepatitis, Public Policy, Public Health, United Nations, Human Rights, Syringes, Great Britain, Australia, Asia, Southeastern, Thailand, Nepal, Human, ICA11
