Despite decades of harshly punitive policies aimed at reducing illicit drug use, the US has the world's highest rates of drug use, according to a study using World Health Organization (WHO) data that compared global drug use rates. Harsh drug laws do not correlate "simply" with drug use rates, the study found -- a finding critics of drug prohibition were quick to jump on.

[inline:who-logo.jpg align=right caption="World Health Organization logo"]The study, Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys, examined a cohort of some 54,000 people in 17 countries who had undergone WHO's Composite International Diagnostic Interview (CIDI) and looked at their use of four drugs: alcohol, cannabis, cocaine, and tobacco.

Not all countries in the world were included, rates of participation varied from country to country, and researchers acknowledged uncertainty about the reliability of people reporting their own drug use. "Nevertheless, the findings present comprehensive data on the patterns of drug use from national samples representing all regions of the world," said the report's editors.

The study found that 16.2% of Americans had tried cocaine at least once, more than three times the number in any other country surveyed. In four countries (Colombia, Mexico, Spain, and New Zealand), use rates were between 4% and 5%, while in five others (Belgium, Germany, France, Italy, and the Netherlands), use rates were between 1% and 2%. In the remaining countries in the survey (Israel, Ukraine, Lebanon, Nigeria, South Africa, Japan, China), use rates were under 1%.

Americans led in cannabis consumption as well, with 42.4% of adults reporting having tried the drug at least once, although New Zealand, with 41.9%, was only a few tenths of a percentage point behind. The cannabis-friendly Netherlands was a distant third at 19.8%, followed by France (19.0%), Germany (17.5%), and Spain (15.0%). Use rates for Asian and African countries were significantly lower.

A vast majority of survey participants from the United States, Europe, Japan and New Zealand had consumed alcohol, compared to smaller percentages from the Middle East, Africa and China. The data also revealed socioeconomic patterns in drug use. Single young adult men with high income had the greatest tendency to regularly use drugs, although researchers reported women were rapidly closing the existing gender gap in drug use.

"Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones," the researchers concluded, citing in particular the difference in cannabis use rates in the punitive US (42%) versus those in the land of Dutch cannabis coffee shops (20%).

The point that drug policy seems to have little impact on drug use rates is not new -- researchers such as NYU's Harry Levine and now-retired Dutch academic Peter Cohen have been trumpeting similar findings for years -- but it is worth repeating, again in the researcher's own words: "The US, which has been driving much of the world's drug research and drug policy agenda, stands out with higher levels of use of alcohol, cocaine, and cannabis, despite punitive illegal drug policies... The Netherlands, with a less criminally punitive approach to cannabis use than the US, has experienced lower levels of use, particularly among younger adults. Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in nation level rates of illegal drug use."

Surprisingly, the Office of National Drug Control policy seemed to agree, with its spokesman, Tom Riley, telling Bloomberg News Service in response to the study that trying to find a link between drug policy and drug use doesn't make sense. "The US has high crime rates but we spend a lot on law enforcement and prison,'' Riley said. "Should we spend less? We're just a different kind of country. We have higher drug use rates, a higher crime rate, many things that go with a highly free and mobile society."

That's not a line the drug czar's office commonly takes. Instead, it more typically rails against reforms "sending the wrong message," but Riley was singing a different tune when confronted with the research findings.

The Marijuana Policy Project (MPP) agrees. In an op-ed submission by MPP communications director Bruce Mirken, the group called US drug policies "a crashing failure" and hailed the study. "This study is important because it's the first time a respected international group has surveyed drug use around the world, using the same questions and procedure everywhere," Mirken wrote. "While many countries have their own drug use surveys, the questions and methodology vary, and comparisons between countries are difficult. This new study eliminates that problem."

And Mirken found himself in the unusual position of agreeing with Riley. "In fact, ONCDP's latest excuse for the failure of US drug policies -- that enforcement and penalties don't really have much effect on rates of use -- is probably just about right. But it also dynamites any justification for our current marijuana laws."

It also begs the question of why, in the face of evidence that treating drug use harshly and inhumanely doesn't work, we continue to resort to it.