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精神活性物质的非刑罪化与明智监管:一种替代禁令的现代方式。

Decriminalisation and smart regulation of psychoactive substances: a modern alternative to prohibition.

作者信息

Mravčík Viktor

出版信息

Cas Lek Cesk. 2023;162(6):231-237.

Abstract

Prohibition has been the globally dominant concept for the regulation and control of psychoactive substances for nearly 70 years. Its effectiveness and legitimacy as a sustainable solution to the problems associated with the existence of psychoactive substances in society has been repeatedly questioned. It is based on the normative assumption that the use of psychoactive substances for other than therapeutic purposes is not allowed, and non-medical supply should be severely punished. This precludes the use of the full range of regulatory, public health, prevention, and harm reduction strategies, reduces well-being, and increases harms for the human-rights, health, and social cohesion. It is time to replace the prohibitionist paradigm with modern regulation that considers the different harms and risks of psychoactive substances, but also the benefits of psychoactive substances for mental health and well-being, lifestyle, and socialisation. This new paradigm (the so-called 'smart regulation') should accept non-medical use of psychoactive substances, apply criminal law as an exceptional tool to regulate human behaviour, regulate the availability of substances according to their harmfulness, regulate the risk profile of the product, strictly regulate marketing and advertising, protect minors and 'others' from the use and supply of psychoactive substances, protect the legal market from the supply of substances from the illegal market, and use economic instruments to regulate demand and to subsidise prevention and treatment.

摘要

近70年来,禁令一直是全球管控精神活性物质的主导理念。其作为解决社会中精神活性物质存在相关问题的可持续解决方案的有效性和正当性一直受到反复质疑。它基于这样一种规范性假设,即禁止将精神活性物质用于治疗目的以外的用途,非医疗供应应受到严厉惩罚。这排除了使用一系列全面的监管、公共卫生、预防和减少伤害策略,降低了幸福感,并增加了对人权、健康和社会凝聚力的危害。现在是时候用现代监管取代禁令范式了,这种现代监管既要考虑精神活性物质的不同危害和风险,也要考虑精神活性物质对心理健康和幸福感、生活方式及社交的益处。这种新范式(即所谓的“明智监管”)应接受精神活性物质的非医疗使用,将刑法作为规范人类行为的特殊工具,根据物质的有害性来规范其可得性,规范产品的风险状况,严格规范营销和广告,保护未成年人及“其他人”免受精神活性物质的使用和供应影响,保护合法市场免受非法市场物质供应的影响,并使用经济手段来调节需求以及为预防和治疗提供补贴。

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