What would Mills have to say about MDMA?

MDMA is illegal to manufacture, import, distribute and use. There should be good reasons for that, so getting philosophical about MDMA isn't just for sunrise chats with friends.John_Stuart_Mill_by_London_Stereoscopic_Company__c1870.jpg

British philosopher John Stuart Mill argued “the only purpose for which power can rightfully be exercised over a member of the civilised community against [their] will is to prevent harm to others”. The principle described by Mill is commonly referred to as “the harm principle”. Mill states that one’s “own good, either physical or moral, is not a sufficient warrant” for state intervention and believes that people have a right to “live as seems good to themselves”, so long as they do not violate the rights of others.

The harm principle is generally accepted in modern democracy. There are some exceptions, for example, children do not always have the capacity to make certain decisions and therefore require protection from themselves in many circumstances. For adults, harm to others appears to be the fairest and most logical reason for prohibiting drug use.

Consistent with Mill’s idea of harm, the Oxford Dictionary defines harm as “physical injury, especially that which is deliberately inflicted”, including both “material damage” and “actual or potential ill effects or danger”. To justify criminalisation, it's generally accepted that the harm to others must be serious, non-trivial, substantive, direct and sufficiently proximate. MDMA doesn't cause that sort of harm.

The Independent Scientific Committee on Drugs (ISCD) has ranked 20 popular legal and illegal drugs in terms of the harm that users cause to other people. MDMA is close to the least harmful, ranked at number 18, with only lysergic acid diethylamide (LSD) (19th) and magic mushrooms (20th) scored as less harmful to others. (The drug that scores the highest of all drugs for harm to others is alcohol.

The ISCD calculations take into account various societal harms such as family adversities, economic cost and community harm. The damage to society caused by MDMA use pales in comparison to many legal activities. To put things into perspective, harms are just as likely to occur as a result of people engaging in risky sport.

A common reason why drug use is considered harmful to others is that drug use impairs judgment, reduces inhibition and makes people more likely to commit acts of crime and violence. MDMA certainly does not predispose users to violence or aggression, and users do not present problems for police, even in large crowds.

The harms caused by criminalisation and the poorly regulated illicit market far outweigh the social harms of MDMA use. There is no guarantee as to the content of illegally manufactured ecstasy pills. This increases harm to all users by making pills more dangerous due to variable strengths of MDMA and the presence of other more dangerous drugs and harmful adulterants. The prohibition of MDMA contributes to the prevalence of illegal organised crime. Attempts to enforce prohibition of the manufacture, importation, distribution and use of ecstasy is a continuous and costly struggle for law enforcement, even while pills reportedly remain easy to obtain.

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A drug rating scale produced by results from the 2013 Global Drugs Survey, and taking into account both the negative and positive effects, ranked ecstasy higher than all other drugs (including alcohol) for ‘net pleasure’. Considering the enjoyable experiences described by MDMA users, it reasonable to believe the drug has social benefits, not unlike catching up with friends for a few relaxing drink

The prohibition of certain psychoactive substances is one of the most notable departures from the harm principle with respect to adult behaviour. The prohibition of MDMA has never been backed up with evidence that MDMA use has significant negative effects on society. In fact, the available evidence shows that MDMA users are unlikely to cause direct harm to anyone, nor do their actions have a significant negative impact to society.

 

This is the third part of a series, based on Josh’s paper ‘The case for MDMA (ecstasy) regulation’ (http://www.ncbi.nlm.nih.gov/pubmed/26349381) published in the Journal of Law and Medicine, June 2015, 22(4):823-45. The paper challenges the medical and legal case for preventing legal access to MDMA and criminalizing users, and proposes a properly regulated alternative. Access the full text with references here

Read part one - Why is MDMA illegal, anyway? - here

Read part two - The risks of MDMA: hysteria and hypocrisy vs the evidence - here


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