Last month, Mayor of London Sadiq Khan became the latest in a string of regional and fringe political figures on the European left to take a stand on drug policy. It marks a contrast to the approach of national left-of-centre parties, for whom drug policy seems to be a taboo subject tainted by controversy and radicalism. But Khan is right: the left should be concerned with drug policy and should not be afraid to take a political leap.
Taking a look at election manifestos over the last five years of those left parties in Western Europe with a serious chance of gaining power, one finds a remarkable lack of ambition. For example, recent commitments by the major left parties in the United Kingdom and Norway have been limited to establishing commissions to investigate policy proposals, despite the fact that dozens of such commissions worldwide have already done the work for them. In Spain, the Socialists remain wedded to a prevention-first approach. The Belgian Socialists have only lukewarm words on a more health-focused approach at the same time as they advocate drug courts, a policy widely criticised as a smokescreen for criminalisation. In Switzerland and Sweden, there is no mention of drug policy at all in campaign material. The status quo goes almost entirely unchallenged.
Meanwhile, fringe, regional and local parties and governments are the ones willing to push the envelope. Across Europe, Green, left-wing and libertarian parties consistently call for a different approach to drugs. Devolved or local governments might be willing to make a change, but generally have little influence over criminal law or national budgets, and are therefore often hamstrung by national policies (such as in the case of the drug consumption rooms advocated by the Scottish National Party but thwarted by Westminster).
This all despite the fact that drug policy should be a big deal. What we are doing is not working, and the numbers involved are staggering. Drug offences are the biggest contributor to incarceration in Europe: almost one in five people in prison in 2020 were there on a drug charge. At least 5,141 people in the European Union, and likely many more, died from drug-related overdoses in 2019. More than three-quarters of those involved opioids. Those are deaths that the World Health Organisation tells us are entirely preventable. One in 20 new cases of HIV are among people who inject drugs, and they are far more likely to go on to develop AIDS. In total, more than 83 million people in Europe have used illegal drugs. It is an issue that touches all our lives.
The left in particular should be paying attention. Poor and otherwise marginalised people face the brunt of the negative impact of the status quo. Criminalisation, stigma and discrimination against drug users mean they do not access health services, something even more acute when it comes to women and gay, lesbian, bisexual and trans people. Poverty is a major factor in how drugs and drug policy affect your life. If you’re well off and well connected, you get to be a Secretary of State. If you’re not, you are more likely to lose your job, develop health problems or become involved in crime. In many ways, it is the classic case against conservative-liberal individualism. How drugs affect your life depends not on some abstract measure of moral fortitude, but the social and material conditions into which you are born.
The evidence for a different approach is strong. Portuguese decriminalisation, though imperfect, saw HIV infections and overdoses drop drastically and avoided thousands of prison sentences. A regulated supply, often referred to as legalisation, would make both drugs and our society safer, reducing deaths and other health harms as well as taking the market out of the hands of criminals at home and abroad. If decriminalisation and regulation seem a bridge too far, there is a vast range of policies available to reduce the harms of illegal drugs. Drug consumption rooms, already in place in at least 10 European countries (though absent in many more), reduce disease and overdose while connecting people to health and social services. Drug checking lets people know what is in their pill or powder, removing a huge part of the health risk. We even have an antidote to opioid overdose – naloxone – which can be administered as easily as an EpiPen.
Is it a case of good policy, bad politics? Are these policies, with the ability to save and change lives, just untenable for the voter? Perhaps the law-and-order approach is too much of a vote-winner. It would certainly explain why the politicians who do advocate for reform tend to be retired. However, the little polling that has been done of such issues tends to demonstrate support, especially when it comes to cannabis legalisation. Even if one accepts a need to avoid the political challenges of decriminalisation and regulation, it is hard to imagine that expanding health and social care for people who use drugs is that much of a vote mover in either direction.
Even if we find that the electorate is not supportive, leadership matters. Public opinion is not static, and it can be gradually influenced and won over, whether through rational argument, national experience or appeals to self-interest. The argument about drugs is ultimately a choice between criminalisation or health, control or liberty, marginalisation or equality, and stigma or compassion. It seems clear which side of the divide the left should fall.