Regulate antibiotics not recreational drugs, ethicist argues

Governments worldwide should stop wasting money on criminalizing recreational drugs and use those funds to curb antibiotic misuse, a medical ethicist suggests.

Philosophy Prof. Jonny Anomaly of Duke University in Durham, N.C., called the war on drugs "unwinnable and morally dubious," in his paper published this week in the Journal of Medical Ethics.

"Most of the violence and crime associated with narcotics is caused by laws that prohibit drug use, rather than drug use itself," Anomaly wrote. 

Anomaly defines recreational drugs as illegal narcotics such as heroin and marijuana, illegal stimulants such as cocaine, and legal drugs that people take to relieve pain, reduce anxiety, induce euphoria etc.

The claim that stimulants tend to make people violent has little evidence, Anomaly said. In contrast, when Portugal decriminalized recreational drugs, there was not a big increase in consumption.

But antibiotic resistant infections often kill people or impair their health making the infections much more expensive to treat, Anomaly wrote.

The collective harms of antibiotic use pose a serious threat. Although individual patients and doctors perceive benefits from antibiotics,it would be better to reserve them for serious infections, he claims.

"My use of antibiotics may lead to an increased risk of infection by another person by subtly influencing the composition of our microbial environment," he wrote.

"Instead of a fully free market for antibiotics, I have argued that we should think hard about how to regulate them in a way that carefully balances individual liberty and public health."

Anomaly explains that adding user fees on use of antibiotics promotes social benefits by conserving existing treatments. The revenue could also fund costly research into new antibiotics that are not patentable in the short-term — a public good.

He acknowledged that a user fee would not be a panacea but argued it could be part of a multi-pronged approach that includes:

• Phasing out the use of these drugs in farming.
• Cash incentives for pharmaceutical companies to conserve existing drugs.
• Banning over-the-counter sales of antibiotics in developing nations.
• Global surveillance of resistant bacteria, spearheaded by wealthy countries.