A Call for International Reform of Drug Policies to Improve Public Health

A leading global public health commission is calling for new policies that would transform our approach to drug use, addiction, and control worldwide, including the decriminalization of minor and non-violent drug offenses. Instead of positively affecting drug markets or drug use, the war on drugs and zero-tolerance policies have in fact weakened certain public health policies across the globe, according to a new report by the Johns Hopkins Bloomberg School of Public Health and The Lancet, which found that the war on drugs has done more harm than good for public health.

The “war” on drugs means prohibiting all use, possession, production, and trafficking of illicit drugs. However, these laws are based on ideas about drug use and drug dependence that have limited scientific evidence, said Commissioner Chris Beyrer, MD, MPH, an epidemiology professor at the Johns Hopkins Bloomberg School of Public Health.

“The global ‘war on drugs’ has harmed public health, human rights and development. It’s time for us to rethink our approach to global drug policies, and put scientific evidence and public health at the heart of drug policy discussions,” Dr Beyrer said.

Part of the international drug reform that the global commission is calling for includes decriminalization of minor and non-violent drug use, possession and petty sale. The other practices that need to be implemented are enactment of policies that reduce violence and discrimination in drug policing and a greater investments in health and social services for drug users. Increasing access to controlled medicines could also help reduce the risk of overdose deaths. These approaches could help better the health and wellbeing of all people.

The Commission found strong evidence proving that strict drug control policies increase the risk of death from overdose. Because sometimes, access to even medications such as naloxone, which can quickly reverse overdoses, becomes restricted under these harsh policies. This would be a crucial policy change especially because opioid overdoses are currently at an all-time high in North America.

Also, enforcement of drug control policies compromises the wellbeing and health of the drug users and the communities the policies are intended to protect. For example, needle and syringe programs are heavily policed. But because of the strict policies, the number of incidences of unsafe injections contributing to the spread of HIV, hepatitis C, and tuberculosis worldwide has increased significantly.

The same holds true for harsh policies that call for incarceration of individuals for minor drug offenses and violations of drug paraphernalia laws. Such mass incarceration of African Americans and Hispanics for non-violent drug crimes has led to deterioration of families and communities.

“Decriminalization of non-violent minor drug offenses is a first and urgent step in a longer process of fundamentally re-thinking and re-orienting drug policies at a national and international level. As long as prohibition continues, parallel criminal markets, violence and repression will continue,” said Commissioner Joanne Csete, PhD, MPH, from the Mailman School of Public Health at Columbia University.