Effective Drug Control: Toward A New Legal Framework

fraud, selling small amounts of drugs, frequent thefts and prostitution. 345 Britain’s recent
drug policy shift reflects the willingness to find more effective means to address the
unreasonable public and economic costs of drug addiction, health care, criminal justice
and lost productivity.
Heroin prescription has also come to North America, as the Canadian government
has approved pilot projects in Vancouver, Toronto and Montreal, involving 470 subjects
with one-third in each trial site. The participants will be randomly assigned to three
different groups: the control group who will receive strictly methadone maintenance
treatment; the group who will receive prescription heroin in addition to methadone
maintenance therapy; and a small subgroup who will receive hydromorphone (also
known as laudanum), which is a medically available opioid. 346 Addiction medicine
physician specialists will monitor individual prescriptions and social workers will assist
with access to community resources, including addiction treatment, housing and job
training. Clinic staff will guide all those ready towards treatments which get them off
drugs altogether. After 12 months, participants will be aided through a transition period,
and then monitored by the research team for up to two years to determine the study's
longer-term outcomes. 347 The North American Opiate Medication Initiative (NAOMI)
began recruitment of heroin users in February 2005. The recruitment period is expected
to take six to nine months. 348
Given the previous reactions of the United States and the United Nations to
Canada’s approval of cannabis decriminalization and of supervised drug injection
facilities, 349 the advent of heroin prescription to North America could further chill
Canadian-American relations.
Legalization and Regulation
As outlined above, many industrialized nations have developed pragmatic policies
that challenge the bounds of drug prohibition, from the official non-enforcement of
cannabis laws to state-sanctioned supervised injection facilities and heroin prescription
programs. Nowhere in the world, however, has any state dared to defy the global
prohibition regime at its core by asserting regulatory control over the production and
distribution of currently prohibited drugs as a means of eliminating the “black” market
and its attendant social harms.
To a very limited extent, a few countries have established regulated supplies of
cannabis for medical purposes. The Netherlands already provides government-contracted
supplies of cannabis to pharmacies to ensure that a safe, controlled and reliable source of
the plant is available. 350 Pilot programs for medical cannabis availability in pharmacies
have also begun in Canada 351 and in Spain. 352 In addition, the Israeli government is trying
an experimental program that administers cannabis to Israeli soldiers, traumatized by war
with the Palestinians, to treat post-traumatic stress disorder. 353 Even the heroin
prescription programs in Europe and Canada, however, are made possible through
specific, carefully circumscribed exemptions from the prohibition-based legal framework
and not through any fundamental change of that framework.