As someone with a libertarian bent, I was taken aback by the persuasiveness of author Theodore Dalrymple’s arguments in his 1997 essay Don’t Legalize Drugs.^[1] I’ve assumed for a long time, without ever investigating or challenging my belief, that full decriminalization and legalization of all drugs would do society more good than harm. But Dalrymple’s essay made me reconsider my position.

Dalrymple worked as a psychiatrist in a poor British neighborhood for over 20 years. He’s seen the dredges of society and that largely shaped his worldview. In his essay, he steers clear of any puritanical or moral arguments that doing drugs is bad, and instead examines what effect they have on society holistically.

He states that the proponents of drug legalization, with whom he disagrees, have two principle arguments: philosophic and pragmatic. Dalrymple contends that each of them are flawed.

(1) The philosophic argument

Dalrymple opens by first providing a definition:

The philosophic argument is that, in a free society, adults should be permitted to do whatever they please, always provided that they are prepared to take the consequences of their own choices and that they cause no direct harm to others.

He believes this philosophy works nominally, but falls apart when it's put into practice:

It might be argued that the freedom to choose among a variety of intoxicating substances is a much more important freedom and that millions of people have derived innocent fun from taking stimulants and narcotics. But the consumption of drugs has the effect of reducing men’s freedom by circumscribing the range of their interests. It impairs their ability to pursue more important human aims, such as raising a family and fulfilling civic obligations. Very often it impairs their ability to pursue gainful employment and promotes parasitism.

In practice, of course, it is exceedingly difficult to make people take all the consequences of their own actions. Addiction to, or regular use of, most currently prohibited drugs cannot affect only the person who takes them—[consider] his spouse, children, neighbors, or employers. No man, except possibly a hermit, is an island; and so it is virtually impossible for [the philosophic] principle [of absolute personal freedom] to apply to any human action [whatsoever], let alone shooting up heroin or smoking crack. Such a principle is virtually useless in determining what should or should not be permitted.

In sharp contrast to Dalrymple’s concern for people affected by addiction, there’s a college professor who advocates microdosing heroin and the legalization of all drugs for adults. The professor states that the majority of adults can use hard drugs recreationally without falling prey to addiction. Some research suggests that, depending on the drug of choice, upwards of only “25% of illicit drug users have a substance use disorder.”

So, while the professor is technically correct that the majority of people could avoid developing an addiction from using hard drugs, he misses the point. Namely, that as a society we protect vulnerable subpopulations from themselves at the cost of everyone else’s freedom. It’s the same reason we don’t permit children to drive—while it would be convenient to have your eight-year-old do your grocery shopping, their developing brains could inadvertently bring harm to themselves or others.

A few months ago I walked into my gym’s sauna and the guys in there were talking about their "addictions" to their phones. One physically fit man mentioned that TikTok is incredibly addictive for him. I dryly said, “for me it’s heroin.” The other guys chuckled at what I intended to be a joke, but the physically fit man took me seriously and said, “oh, you also use heroin?” Apparently he recreationally uses it, along with other drugs like crack cocaine and meth. 

I asked, “You don’t have any problems with addiction?”

“Nope. It’s just a fun thing to do a couple times per year.”

“Can I ask, what got you into doing hard drugs?”

He told me that in college, with one of his friends, they started experimenting with hard drugs. That's when he found out that drugs are fun and don’t cause any issues for him. His friend, however, went on a five-year meth bender followed by several decades of being homeless.

I followed up and asked, “Is there anything in life that you feel addicted to?”

“TikTok. When I start scrolling, I'll look up and somehow eight hours have passed.”

Dalrymple further criticizes the philosophic argument by stating:

The idea that freedom is merely the ability to act upon one’s whims is surely very thin and hardly begins to capture the complexities of human existence; a man whose appetite is his law strikes us not as liberated but enslaved. And when such a narrowly conceived freedom is made the touchstone of public policy, a dissolution of society is bound to follow. No culture that makes publicly sanctioned self-indulgence its highest good can long survive: a radical egotism is bound to ensue, in which any limitations upon personal behavior are experienced as infringements of basic rights.

So the legalization of drugs cannot be supported by philosophical principle. But if the pragmatic argument in favor of legalization were strong enough, it might overwhelm other objections. It is upon this argument that proponents of legalization rest the larger part of their case.

(2) The pragmatic argument

Before criticizing it, Dalrymple starts by steelmanning the argument for why drugs should be legalized:

The [pragmatic] argument is that the overwhelming majority of the harm done to society by the consumption of currently illicit drugs is caused not by their pharmacological properties but by their prohibition and the resultant criminal activity that prohibition always calls into being. Even many of the harmful physical effects of illicit drugs stem from their illegal status: for example, fluctuations in the purity of heroin bought on the street are responsible for many of the deaths by overdose. If the sale and consumption of such drugs were legalized, consumers would know how much they were taking and thus avoid overdoses.

Moreover, since society already permits the use of some mind-altering substances known to be both addictive and harmful, such as alcohol and nicotine, in prohibiting others it appears hypocritical, arbitrary, and dictatorial. Its hypocrisy, as well as its patent failure to enforce its prohibitions successfully, leads inevitably to a decline in respect for the law as a whole.

It stands to reason, therefore, that all these problems would be resolved at a stroke if everyone were permitted to smoke, swallow, or inject anything he chose. The corruption of the police, the luring of children of 11 and 12 into illegal activities, the making of such vast sums of money by drug dealing that legitimate work seems pointless and silly by comparison, and the turf wars that make poor neighborhoods so exceedingly violent and dangerous, would all cease at once were drug taking to be decriminalized and the supply regulated in the same way as alcohol.

Dalrymple hints, through his laissez-faire exaggeration of a drug free-for-all, that perhaps large social issues won’t automatically resolve themselves with happily-ever-after fairytale endings if drugs are legalized. He next highlights what the road-to-hell can look like when well-intended policies are enacted:

It is of course true, but only trivially so, that the present illegality of drugs is the cause of the criminality surrounding their distribution. Likewise, it is the illegality of stealing cars that creates car thieves. Moreover, the impossibility of winning the “war” against theft, burglary, robbery, and fraud has never been used as an argument that these categories of crime should be abandoned.

In any case, there are reasons to doubt whether the crime rate would fall quite as dramatically as advocates of legalization have suggested. The idea behind crime—of getting rich, or at least richer, quickly and without much effort—is unlikely to disappear once drugs are freely available to all who want them.

Having met large numbers of drug dealers in prison, I doubt that they would return to respectable life if the principal article of their commerce were to be legalized. Far from evincing a desire to be reincorporated into the world of regular work, they express a deep contempt for it and regard those who accept the bargain of a fair day’s work for a fair day’s pay as cowards and fools. A life of crime has its attractions for many who would otherwise lead a mundane existence. So long as there is the possibility of a lucrative racket or illegal traffic, such people will find it and extend its scope. Therefore, since even legalizers would hesitate to allow children to take drugs, decriminalization might easily result in dealers turning their attentions to younger and younger children, who—in the permissive atmosphere that even now prevails—have already been inducted into the drug subculture in alarmingly high numbers.

Alarmingly high numbers… Is that accurate? According to the CDC: “15% of high school students reported having ever used select illicit or injection drugs—cocaine, inhalants, heroin, methamphetamines, hallucinogens, or ecstasy.” 

Young people’s brains are still developing. They make risky decisions. And those decisions can have long-term consequences. The CDC reports that “the majority of adults who have a substance use disorder started using substances during their teen and young adult years.”

Dalrymple continues with what happens when the well-intended government opts to become the local drug dealer:

Why do addicts given their drug free of charge continue to commit crimes? Some addicts, of course, continue to take drugs other than those prescribed and have to fund their consumption of them. So long as any restriction [whatsoever] regulates the consumption of drugs, many addicts will seek them illicitly, regardless of what they receive legally. In addition, the drugs themselves exert a long-term effect on a person’s ability to earn a living and severely limit rather than expand his horizons and mental repertoire. They sap the will or the ability of an addict to make long-term plans.

For the proposed legalization of drugs to have its much vaunted beneficial effect on the rate of criminality, such drugs would have to be both cheap and readily available. But price and availability, I need hardly say, exert a profound effect on consumption.

This NIH paper confirms that alcohol is an elastic good. That is, the lower the price of alcohol, the more of it is consumed.

And, of course, with the increased consumption of alcohol comes negative effects to the drinker’s health (in terms of liver damage, gout, alcohol poisoning, etc) and to the health and safety of those around the drinker. According to the WHO, “the relationship between alcohol consumption and aggressive behavior has been well documented in epidemiological studies.” 

That’s just alcohol. What would happen if we legalized even more addictive drugs? Fortunately, we don’t have to wonder. The state of Oregon experimented with full decriminalization in 2020. Their intention was to encourage treatment for addicts, rather than punishing them for drug use. Four years later the experiment was shut down.

Legislators defied their voters’ well-intentioned decriminalization law and made possession of hard drugs a crime again. Why? Choosing not to punish addicts, and making prosecuting dealers more difficult, worsened the existing fentanyl crisis and led to more overdose deaths. 

Another place that famously implemented decriminalization was Portugal. After twenty years from when the policy was first instituted, experts can now evaluate the effectiveness. This article summarizes Portugal's policy:

Drug possession remains illegal, drug possession for personal use is decriminalized, and comprehensive treatment and recovery options become available as a viable next step for the identified user of illegal drugs. 

Before the policy went into effect in 2001, Portugal had record-high heroin usage and HIV infections. So far the policy has had mixed results.

By 2018, Portugal’s number of heroin addicts had dropped from 100,000 to 25,000. Portugal had the lowest drug-related death rate in Western Europe, one-tenth of Britain. HIV infections from drug use injection had declined 90%. The cost per citizen of the program amounted to less than $10/citizen/year while the U.S. had spent over $1 trillion over the same amount of time. Over the first decade, total societal cost savings (e.g., health costs, legal costs, lost individual income) came to 12% and then to 18%.

Even though initial results were positive, in recent years government budget cuts slashed the country’s progress:

The number of Portuguese adults who reported prior use of illicit drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019. Crime, often seen as at least loosely related to illegal drug addiction, rose 14% just from 2021 to 2022. Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared.

This begs the question: what is an addict’s life worth? If they’re not contributing to the economy, are their lives worth less than a regular person's life? These are uncomfortable questions, but Portuguese policy makers implicitly decide the value of addicts’ lives when they choose to withhold tax dollars from (historically successful) addiction programs.

It seems that decriminalization, when implemented properly, has potential. But the lifeblood of these programs, and the life-and-blood of addicts, will perpetually hang in the balance depending upon which political administration is in power.

Putting aside the self-destructive behaviors that drugs can induce, Dalrymple also highlights the danger to bystanders. Certain drugs have pharmacological properties that are known to increase a person’s propensity for violence:

The situation could be very much worse…if we legalized the consumption of drugs. If opiate addicts commit crimes even when they receive their drugs free of charge, it is because they are unable to meet their other needs any other way; but there are, unfortunately, drugs whose consumption directly leads to violence because of their psychopharmacological properties and not merely because of the criminality associated with their distribution. Stimulant drugs such as crack cocaine provoke paranoia, increase aggression, and promote violence. Much of this violence takes place in the home, as the relatives of crack takers will testify. It is something I know from personal acquaintance by working in the emergency room and in the wards of our hospital. Only someone who has not been assaulted by drug takers rendered psychotic by their drug could view with equanimity the prospect of the further spread of the abuse of stimulants.

If it is true that the consumption of these drugs in itself predisposes to criminal behavior, it is also possible that the effect on the rate of criminality of this rise in consumption would swamp the decrease that resulted from decriminalization. We would have just as much crime in aggregate as before, but many more addicts.

Hard drugs like crack cocaine are associated with violence. This NIH paper evaluated the effects of crack cocaine on drug users attending treatment clinics in São Paulo, Brazil. The results:

HIV prevalence was 6.6%. Violence was reported by 97% of the subjects. Acts of violence such as verbal arguments, physical fights, threats, death threats, theft, and drug trafficking were significantly higher among crack users… Prostitution was observed as a means of obtaining drugs. A high number of crack cocaine users had a history of previous imprisonment, many for drug-related infractions.

Finally, Dalrymple challenges the narrative that there’s an easy solution to the problem of drugs:

In claiming that prohibition, not the drugs themselves, is the problem, [many] have said that “the war on drugs is lost.” But to demand a yes or no answer to the question “Is the war against drugs being won?” is [too simplistic].

Let us ask whether medicine is winning the war against death. The answer is obviously no, it isn’t winning: the one fundamental rule of human existence remains, unfortunately, one man one death. Let us then abolish medical schools, hospitals, and departments of public health. If every man has to die, it doesn’t matter very much when he does so.

If the war against drugs is lost, then so are the wars against theft, speeding, incest, fraud, rape, murder, arson, and illegal parking. Few, if any, such wars are winnable.

The present situation is bad, undoubtedly; but few are the situations so bad that they cannot be made worse by a wrong policy decision.

In an ideal world, do I wish responsible adults could decide to use hard drugs for themselves? Yes. But we don’t live in an ideal world.

1. ^{^}

   The essay was first published in the book Our Culture, What’s Left of It.