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Are there any psychiatric drugs that permanently should or should not be legalized?

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In your long experience in Psychiatry , are there drugs that permanently should or should not be legalized? Why?
Posted Thu, 21 Mar 2013 in Medicines and Side Effects
Answered by Dr. Jonas Sundarakumar 4 hours later

In the last few years, many drugs - prescription and non-prescription drugs - have come under a lot of debate with regards to legalization. Before we analyze about these drugs, it is first important to understand why there is so much of hue and cry over this subject.

Humans have been using psycho-active substances from time immemorial. In the last few decades, that there has been a lot of research into the chemical, medicinal and psycho-active properties of these substances. It is only more recently that a clearer understanding has been gained into the short-term and long-term adverse effects of these substance, such as causation or precipitation of medical and psychiatric problems. This has led to health regulatory bodies placing regulating on their use and governments formulating laws restrictions their use.

Among the many controversial drugs which are debated for leagalization, the most debated ones are:
1) Cannabis
2) Opium / opioids
3) Stimulants such as amphetamines

The reasons behind arguing for legalization are:
1)     Many of these drugs are claimed to have medicinal uses – for example opioids in the management of chronic intractable pain, cannabis in the treatment of terminally ill (palliative care), PTSD or other stress-related disorders, amphetamines in the management of chronic depression, etc. etc.
2)     Curbing or restricting the use of these drugs amounts to imposing unnecessary restrictions on a person’s freedom of choice. Many argue that each individual is a responsible member of the society and each person should be allowed to make his / her choices freely.
3)     Some even argue that not legalizing these drugs would only lead to circulation of ‘unsafe’, spurious or contaminated drugs which may cause potential dangers and even death.

In my opinion, I strongly feel that none of these drugs should be permanently legalized. Now, this opinion should not be mistaken as just a “conservative” or “narrow-minded” view, but rather I have a lot of reasons to believe this from my clinical experience in dealing with hundreds of drug users and addicts.

The reasons are:
1)     Though many claim medicinal properties and medical uses of these substances, let me tell you that no drug is so “vital” or better than any of the already available forms of treatment. Even if there are specific and essential uses of these drugs (for example opioids in the treatment of severe or intractable pain), the option of prescribing them within the legal boundaries is always available.

2)     Coming to the point of individual freedom and choice – it is important to understand that though each individual has his / her own freedom of choice, it is essential to make a “responsible choice”. An person not only has an individual responsibility towards himself, but also has a responsibility towards the society. It is very well known that these drugs have a high abuse and addictive potential and can result in a lot of adverse health consequences. We also know that even when these drugs have legal restrictions, the abuse and addiction rates are alarmingly high. In this case, imagine what would be the impact of removing any legal restrictions or regulations!

3)     Unlike what some claim, legalizing these drugs will never lead to responsible use. Take the simple example of substances which are currently legal – tobacco and alcohol. It has been established beyond doubt that these two substances are the largest contributors to morbidity and mortality in today’s world. People had the “freedom” and “choice” to use alcohol responsibly. The government and health authorities did not place any legal restrictions, but just gave “health advisories” and “recommendations” regarding safe drinking. But what is the end result? Millions affected by alcohol-related diseases every year; more than 75,000 alcohol-related deaths every year! So, there is enough and more proof that legalizing these drugs will never lead to safe or responsible use.

4)     It is also important to remember that the government has a responsibility for its citizens. In most countries the responsibility of healthcare is taken up by the government and so, it is well within the rights of the government to enact laws which will protect the health of its citizens from adverse consequences due to these drugs.

5)     There is also enough evidence that drug abuse is linked to an increase in crime rates. Every country or state department's police records will support this fact.

6)     Even regarding “mild drugs” like marijuana, I am convinced from my experience in practicing psychiatry, that it does act as a gateway drug, leading to the use of other more XXXXXXX illicit substances.

7)     Even in cases where people claim that drugs like marijuana are alternative remedies for managing psychological problems and stress / anxiety-related disorders, I would disagree with this notion. Marijuana is definitely not a better or safer alternative to the currently available psychiatric treatments. (Marijuana itself is associated with triggering or worsening of a variety of psychiatric problems like anxiety disorders, psychosis, etc.). Marijuana also delays people from actually searching for the root emotional causes of their problems. They get high, instead of getting to the core of what is bothering them and taking remedial measures.

So, my opinion is that today’s world is still not ready enough to make responsible choices to handle legalization of any of these drugs. The adverse consequences and potential risks due to these drugs are way too much in order to even take this chance. Legal restrictions and regulations are necessary by governments to safeguard its citizens from these adverse health consequences due to these drugs.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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