Harm reduction on a social level

Back in January, I pointed out that the legal prohibition approach cannot work in cases where the thing being prohibited is felt to be necessary or highly desirable by the population or a large part of it.  Alcohol prohibition, to use the most obvious example, didn't stop millions of people from drinking.  It just drove the alcohol industry underground where it was impossible to regulate, and enriched organized crime.  Our current bans on drugs and sex work do not prevent millions of people from accessing those things.  They just drive those industries underground where they are impossible to regulate, and enrich drug cartels, pimps, and human traffickers.  Prohibition of guns or abortion, which some present-day fanatics aspire to impose, would almost certainly have similar results.  Availability of guns and abortion wouldn't be reduced much -- they would be supplied by illegal or underground networks of various kinds which would quickly arise to meet the demand which could no longer be met via lawful means.

In that post, I emphasized the fact that prohibition inevitably fails to meet its goals, but neglected the other side of the problem -- that prohibition actually makes things worse.  It's not just that tens of millions of people kept right on drinking alcohol during the time of prohibition, it's that life became more dangerous for all concerned.  Not only were organized crime gangs empowered and enriched, but anyone trying to get access to alcohol had to deal with the illegal sector of the economy, which meant dealing with dangerous characters, and the constant threat of arrest.  Illegal alcohol could not be regulated and kept reasonably safe to drink, as we do today with it as a legal product.

Today's prohibition laws have similar effects.  People who want hard drugs have to get them from pushers or other sleazy characters who can be dangerous to deal with.  Everyone involved has to worry about being arrested at any time.  You can't be sure the drugs you're getting aren't "cut" with something downright dangerous.  Dosages, purity, etc are a crapshoot, not regulated the way legal products are.  Because sex work is illegal, sex workers can't go to the police about violent clients.  They can become dependent on pimps, and again, cannot go to the police if those become abusive, as they often do.  The general sleaze and chaos make everyone involved feel unsafe.  Human trafficking thrives.

Most people don't want to deal with the illegal sector of the economy precisely because it's so unpleasant and dangerous.  Given a lawful alternative, they will prefer it.  Nobody today buys their alcohol from gangsters, since they can get it from an ordinary store, knowing that doing so is safe and that the product has been produced under proper regulation and is safe to drink.  With sufficiently liberal legalization and normalization of drugs and sex work, the drug gangs, pimps, and traffickers would similarly see their markets dry up.  And if drugs and sex work were fully legal, they could be intelligently regulated, greatly improving safety for providers and customers alike.

On the individual level, this concept is called "harm reduction".  The harm reduction approach recognizes that it's impossible to stop people from engaging in certain undesirable activities, and seeks instead to mitigate the damage.  An example of this would be providing clean needles to drug addicts.  This recognizes that absolutely stopping addicts from using drugs is impossible under realistic conditions, and instead seeks to minimize the spread of HIV and other blood-borne pathogens via needle-sharing.  Such efforts are always in conflict with prohibition laws, where such laws exist.  Fanatics have even opposed giving addicts clean needles on the grounds that it somehow condones or facilitates drug use, preferring to pursue the unattainable goal of total prohibition.  Sex workers, similarly, have developed some ways of making their situation safer, such as advertising for clients in ways that give them some ability to pre-screen them and weed out dangerous characters.  Laws meant to tighten the prohibition on sex work, such as FOSTA/SESTA, invariably make the situation worse by taking such harm-reduction options away.

The legalization/regulation approach, which we applied to alcohol by repealing prohibition and will probably eventually apply to drugs and sex work, is harm reduction on a social level.  It's already in effect, in a rather haphazard way, with guns and abortion.  If the fanatics get their way, we'll lose that.

The term harm reduction is appropriate.  Legalization/regulation does not remove all the bad consequences of the behavior at issue.  It can't.  Nothing can.  Alcohol, hard drugs, sex work, and gun possession all have inevitable negative side effects, some of them serious.  (Abortion really doesn't, but as a medical procedure it involves some minor degree of risk, which would become a far bigger problem if it were illegal and thus mostly performed by back-alley quacks or by doctors without access to proper instruments and resources.)  But once we recognize that the prohibition approach cannot succeed in making those things cease to exist, we can try to strike a rational balance between satisfying strong and widespread desires, and minimizing negative side effects via regulation.  Just as legal alcohol is produced under safe conditions and is subject to procedures to keep it out of the hands of minors, so a legal gun industry can be subject to background checks, registration, and various other controls to reduce the risks inherent in a weapon-saturated society.  Any real attempt to stamp out widespread gun ownership and the legal gun retail industry would (besides leading to massive violent resistance) sweep away all such harm-reduction methods in favor of an un-regulatable underground industry that would spring up to supply the demand.

Harm reduction on a social level will, I think, eventually come to be accepted as the best approach in many areas.  There are a lot of things which are frowned on by puritans or actually bad for society in various ways, but which large numbers of people want or even deem essential.  In most cases, it is simply not in our power to eradicate such things.  The best we can do is put aside the urge to control, recognize the limits of what laws and police can do, and figure out how to let people meet their needs while minimizing the undesirable effects.