A recent editorial published in the British Medical Journal (BMJ) deemed the so-called ‘war on drugs’ a failure. It was followed by an essay by Molly Meacher and Nick Clegg on policy changes that could challenge current ineffective prohibition laws.
Despite the mediatic turmoil the articles have triggered, the arguments they present are simply a matter of observation. Anyone looking at the data can agree that there have been overwhelming shortcomings of the war on drugs. Despite the ban on substances such as heroin, cannabis and cocaine for the last half century, their consumption has not declined over the recent years, with approximately one in 20 adults worldwide having taken illegal drugs in 2014.
Since the first UN treaty from 1961 prohibiting the non-medical use of a list of drugs, in order to “advance the health and welfare of mankind”, countries have spent over $100bn/year criminalising producers, traffickers, dealers and users. Yet, there is still no evidence on the effectiveness of such policies. Drug addiction has been a devastating scourge worldwide and the war on drugs seems to have fed a vicious cycle, disproportionally acting on poor people, ethnic minorities, and women. Prohibition has led to unsafe drug consumption, with illegal concoctions of unknown quality and potency flooding communities, as well as a battlefield of human rights violations and appalling violence. Furthermore, this has resulted in epidemics of bloodborne infections such as HIV and hepatitis C.
Unsurprisingly, experts are advocating a shift in the focus for tackling these issues, suggesting allocating resources on drug trafficking and supply, while treating addiction as a health issue. In a society that increasingly refuses to listen to experts, it is important for healthcare professionals to take an active part in policymaking, putting health at the centre of this debate. As the editors of the BMJ said: “Doctors and their leaders have ethical responsibility to champion individual and public health, human rights and dignity and to speak out where health and humanity are systematically degraded. Change is coming and doctors should use their authority to lead calls for pragmatic reform informed by science and ethics”.
Unfortunately, an issue that has hampered consensus on decriminalisation is the misuse of the term and amalgams often made with legalisation when, in reality, decriminalisation only applies to users: it lifts any criminal sanction relating to possession or use of drugs while production and supply remain illegal. A few countries including Canada, Uruguay and the Netherlands have already taken the radical step and are leading change, proving evidence of the cost-effectiveness of the approach that has allowed them take control of supply and fight against organised crime.
More importantly, there is an urgent need to re-evaluate the classification of some drugs such as cannabis, labelled as a “dangerous drug with no medicinal value” by the Misuse of Drugs Regulations, forbidding both its prescription and scientific research. This is in flagrant contradiction to the government’s Medicine and Healthcare Products Regulatory Agency’s (MHRA) recognition of the medicinal benefits and potential of cannabidiol (CBD), found in the cannabis plant. The re-evaluation of this drug should facilitate research for inexpensive treatment of many conditions, providing patients with natural medicines to alleviate their symptoms, while also minimising side-effects triggered by synthetic drugs.
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