Formulating policies on the non-medical use of cocaine.

Abstract

The formulation of policy on cocaine, as on any other social issue, involves explicit or implicit cost-benefit analyses with many factors. Cocaine use carries many medical, psychiatric and social risks, and its inherent pharmacological risk of dependence is greater than for other drugs. The reported frequency of these problems has increased exponentially over the past fifteen years. However, current levels of use are decreasing in the general population, though still increasing among certain subpopulations in which it is accompanied by violent crime. On the other hand, the attempt to control use mainly or exclusively by reducing the supply has been of low efficacy and extremely expensive, in both human and monetary terms, for the consuming countries and economically and politically devastating for the producing countries. Yet past experience with other drugs suggests that legalization of cocaine would increase its use substantially. Moreover, legalization runs counter to public sentiment, even in those countries where the law is applied leniently against users and small-scale traffickers. The most practical policy appears to be to maintain prohibition as a sign of social disapproval, but to rely much more heavily on non-coercive measures to reduce demand by strengthening public consensus against all drug use.