文章基本信息

标题：The Limited Relevance of Drug Policy: Cannabis in Amsterdam and in San Francisco
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作者：Craig Reinarman ; Peter D. A. Cohen ; Hendrien L. Kaal 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：5
页码：836-842
语种：English
出版社：American Public Health Association
摘要：Objectives . We tested the premise that punishment for cannabis use deters use and thereby benefits public health. Methods . We compared representative samples of experienced cannabis users in similar cities with opposing cannabis policies—Amsterdam, the Netherlands (decriminalization), and San Francisco, Calif (criminalization). We compared age at onset, regular and maximum use, frequency and quantity of use over time, intensity and duration of intoxication, career use patterns, and other drug use. Results . With the exception of higher drug use in San Francisco, we found strong similarities across both cities. We found no evidence to support claims that criminalization reduces use or that decriminalization increases use. Conclusions . Drug policies may have less impact on cannabis use than is currently thought. There is a trend among Western democracies toward liberalization of cannabis laws. (Cannabis includes both marijuana and hashish.) In 1976, the Netherlands adopted de facto decriminalization. Under Dutch law, possession remains a crime, but the national policy of the Ministry of Justice is to not enforce that law. After 1980, a system of “coffee shops” evolved in which the purchase of small quantities of cannabis by adults was informally tolerated and was then formally permitted in shops that were licensed. 1– 3 During the 1990s, Switzerland, Germany, Spain, Belgium, and Italy shifted their drug policies in the Dutch direction. Portugal decriminalized cannabis in 2001, and England similarly reclassified cannabis in 2004. Canada and New Zealand are currently considering cannabis decriminalization. These shifts constitute the first steps away from the dominant drug policy paradigm advocated by the United States, which is punishment-based prohibition. 4– 6 Moving in the opposite direction, the United States has stiffened criminal penalties for drug offenses and has increased arrests for cannabis offenses. Since 1996, voters in 8 states and the District of Columbia have passed medical-marijuana initiatives, but the federal government has resisted implementation. In 2001, 723 627 people were arrested for marijuana offenses. 7 In 2002, the Drug Enforcement Administration began raiding medical-marijuana organizations, 8 and the White House Office of National Drug Control Policy launched a campaign against marijuana. 9, 10 Such policies are designed to deter use. The core empirical claim made by criminalization proponents is that, absent the threat of punishment, the prevalence, frequency, and quantity of cannabis use will increase and will threaten public health. 11– 16 The question of whether deterring use enhances public health was beyond the scope of our study, but we did examine the proposition that drug policies affect user behavior and deter use. It is possible that the causal arrow points the other way—that user behavior affects laws and policies, which has been the case with alcohol policies in some countries. 17 However, the Marijuana Tax Act of 1937, which first criminalized cannabis, predated widespread cannabis use in the United States and had clear political origins. 18– 21 In the Netherlands, de facto decriminalization of cannabis was first forged in the late 1960s, when use was spreading among the youth counterculture. But Dutch policymakers decided that cannabis use was unlikely to lead to deeper deviance and that criminalization could lead to greater harm to users than the drug itself. 3 In neither country, then, was user behavior the effective cause of laws or policies. The presumed effects of cannabis policies have been explored by those who are critical of criminalization in the United States 22 and by those who are skeptical of Dutch decriminalization. 23 However, until now there have been no rigorously comparative studies of user behavior designed to assess whether criminalization constrains use or whether decriminalization increases it. Our study compared the career use patterns of representative samples of experienced cannabis users in 2 cities with many similarities but with different drug-control regimes—Amsterdam, the Netherlands (decriminalization), and San Francisco, Calif (criminalization). San Francisco was selected as the US comparison city not because it is representative of the United States but because it is the US city most comparable to Amsterdam. Both cities are large, highly urbanized port cities with diverse populations of slightly more than 700 000. They are financial and entertainment hubs for larger regional conurbations, and they have long been perceived within their home countries as cosmopolitan, politically liberal, and culturally tolerant. Law enforcement officials in San Francisco are not as zealous about enforcing marijuana laws as law enforcement officials are in most other US cities. Nonetheless, San Francisco is embedded in the drug policy context of criminalization, which is a markedly different drug policy context than that of Amsterdam. Buying and selling cannabis are permitted in Amsterdam in 288 licensed “coffee shops,” 24 and public use is permitted, whereas in San Francisco, buying, selling, and public use of marijuana remain criminal offenses. In Amsterdam, there is neither proactive nor reactive policing of use or low-level sales, although police do enforce regulations against coffee shops’ advertising, selling to minors, and creating public nuisances. In San Francisco, there is strong proactive and reactive policing of sales, and there is moderate reactive policing of use. These differences in drug policy context are palpable to users. San Francisco students are suspended from schools and are placed in treatment for marijuana use. San Francisco users risk citations, fines, and arrests if they are detected buying, possessing, or using marijuana. In Amsterdam, users face none of these risks. The use and sale of other illicit drugs sometimes used by cannabis users is proactively policed in San Francisco. In Amsterdam, police occasionally engage in reactive policing of complaints about open use or sale of other drugs, but they do not proactively patrol in search of these offenses.