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How to Formulate Drug Policies and Provide Evidence-Based Regulation

Little Figures on a piece of paper with arrows


Steve Rolles, David Nutt & Anne Schlag


April 7, 2021

How do we end the war on drugs?

With mounting evidence continuing to expose the failure of the war on drugs, more governments around the world are opening their eyes to consider alternative drug policies. But which drug policy reforms are the best way forward? Should we simply turn a blind eye and decriminalise all drugs, or legalise drugs to gain strict control over drug-related harms? Should some drugs remain illegal, while others are decriminalised?

In a recent publication, Earp, Lewis, and Hart (2021) make a compelling argument for ending the “war on drugs,”. They highlight the importance of decriminalization of people who use drugs, and evaluating legally regulated market alternatives to drug prohibition. There is a growing consensus that the prohibitionists’ status quo is failing, in the face of an urgent need for drug policy reform. However, there is, less agreement on what shape such reforms should take.

This is unsurprising given the wide array of different drugs, drug using populations, and risk behaviours, as well as the often profound differences in the political and cultural contexts in which illegal drug use and drug markets exist, and the various drug policy and law reform processes that are unfolding.

MCDAs suggest legal regulation

We were recently involved in a Multi Criteria Decision Analysis (MCDA) which sought to explore the impacts of four different approaches to drug market regulation of alcohol, cannabis and heroin:

  1. Absolute prohibition

  2. Prohibition with decriminalization of possession/use

  3. Legally regulated markets under strict state control

  4. Legal commercial “free” markets) for three different drugs

This MCDA highlighted not only the multifaceted nature of drug policy impacts across a broad spectrum of issue areas, but also the reality that different stakeholders will naturally prioritize different outcomes, and that there are often tensions and trade offs between them. We found that the strict state control model of legal regulation to be the cumulative preference across all three drugs considered. The same broad conclusions were reached by a similar MCDA recently undertaken in the Netherlands considering different policy models for MDMA (ecstasy).

The devil is in the details

Drugs are not ordinary commodities; while their differing risk profiles will warrant different degrees and forms of government regulation, these will in almost all cases be over and above those of more conventional products. There is a growing body of analysis on post prohibition regulation models from academia, civil society and government. Much of this work has focused on cannabis regulation, where the debate has moved from speculative debate to real world implementation of legalization and regulation in multiple jurisdictions.

The paradigm shift now occurring in drug policy, away from failed punitive prohibitionist thinking and toward more pragmatic and evidence based public health approaches, continues to accelerate. In any future regulation model, social justice and equity measures need to be hardwired into legislative development from the outset—to not only ensure that the inequities of prohibition are not reproduced in different forms within legal markets, but also to include a reparative element to provide redress for the historic harms of the enforcement of the “war on drugs.” The ongoing engagement of expert voices—including of people who use drugs and the communities disproportionately impacted by the consequences of drug policies—is essential in this context. Policy makers, civil society and academia have an opportunity, and indeed a responsibility to ensure this occurs.

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