As policymakers weigh “what to do about drugs,” they almost always focus on the potential harms of drugs and almost never on the harms of our drug policies themselves. But earlier today an esteemed group of researchers issued a comprehensive report on public health and international drug policy that documents in meticulous detail the catastrophic health consequences of the global war on drugs. Coming together as Johns Hopkins-Lancet Commission on Drug Policy and Health, twenty-six scientists conducted a comprehensive review of the literature and concluded that our drug control policies:
..have contributed directly and indirectly to lethal violence, communicable-disease transmission, discrimination, forced displacement, unnecessary physical pain, and the undermining of people’s right to health.
These findings were not published in some left wing, radical outlet but in the highly regarded medical journal, The Lancet.
For decades, U.S. and global drug policy has been ostensibly aimed at preventing and reducing the use of illicit drugs. However, despite the investment of billions of dollars, our drug policies have failed to meet this objective – drugs remain widely available. Today, we have new, strong, and definitive evidence of what many of us already knew – these policies are not just ineffective; they are deadly.
The Commission notes that the violence associated with the drug trade has resulted in huge increases in deaths in countries, like Mexico, to the point that life expectancy there has actually declined. Repressive policing and the over-reliance on incarceration have worsened public health outcomes, particularly contributing to the spread of infectious disease such as HIV and tuberculosis. Our drug eradication programs spray toxic chemicals on and result in the forced displacement of communities around the globe. Our drug policies have also contributed to overdose deaths by creating unregulated markets where adulterated products flourish, unnecessary controls on the life-saving medication naloxone, and unsafe and rushed injecting practices. And our concern over illicit drugs has also resulted in harmful restriction of our use of certain licit substances in both clinical practice and research. The Commission also notes the ways in which our drug policies have been particularly harmful to people of color and women, as racism and gender bias pervade our response to illicit drugs.
In short, the Commission’s report is a definitive and devastating indictment on global drug policies. So given the disastrous policies of the past, what should we do? The Commission’s solution is quite simple – implement evidence-based policies and interventions. They advise:
At a time when drug-policy discussions are opening up around the world, there is an urgent need to bring the best of non-ideologically-driven health science, social science, and policy analysis to the study of drugs and the potential for policy reform.
Their report make a number of practical suggestions based on their review of the evidence about what works. Too numerous to detail here, a few important recommendations include: decriminalizing minor, non-violent drug offenses, including use, possession and petty sales; a much stronger emphasis on harm reduction, including opioid substitution therapy, syringe exchange programs, and supervised injection facilities; new metrics by which to judge our drug polices that include health, development and human rights indicators; and a gradual move towards regulated drug markets.
The reason the Commission report is so refreshing and exciting is that it seeks to do the very thing that has for so long defied drug policy – to base our response to drugs on rationality, research, and human rights. While such efforts have been ignored in the past, given its authorship and careful documentation, this report could be the one that finally breaks through the misinformation, fear, stigma, and bias that governs global drug policies. I for one am hoping that it ushers in new era where our drug policies are grounded in science and, instead of causing grave harm, truly help individuals, families and communities around the world.