The catastrophic global effects of drug prohibition are multiplying at an alarming rate ("Americas signal major rethink as bloody war on drugs falters", In Focus). Without a complete rethink and the adoption of sensible options, we face a certain escalation in violence, disease, mass incarceration and the undermining of democracy. Economists, scientists, doctors, lawyers and an increasing number of politicians have joined those demanding a transparent review of drug legislation.

Expedient politicians continue to exploit public fear by persuading people that the only choice is more of the same failed policies. This has resulted in the tougher approach becoming so entrenched that even to think of other ways seems to go against the grain. Another favoured tactic of those who promote the old failed policies is to say that any other way is tantamount to promoting drug use.

However, there are increasing signs that the public is no longer prepared to accept this propaganda and of a realisation that it is prohibition that is causing most of the damage.

It is going to take tremendously strong political leadership to move from dogma to science in the way we manage drug use. But one thing we know beyond all doubt is when enough people demand change, politicians swiftly get in line.

Sebastian Saville

Executive director, Release

London EC1

I still don't get it. We are told that the war on drugs has been lost. In the UK, those seriously dependent on illegal drugs constitute about 0.3% of the population, which means that 99.7% are not. If this is defeat, then what will victory look like?

Chris Forse

Stratford upon Avon

There is a middle ground between drug prohibition and blanket legalisation. Switzerland's heroin maintenance programme has been shown to reduce disease, death and crime among chronic users. Providing addicts with standardised doses in a clinical setting eliminates the overdose risk associated with illicit heroin use.

The success of the Swiss programme has inspired pilot heroin maintenance projects in Canada, Germany, Spain, Denmark and the Netherlands. If expanded, prescription heroin maintenance would deprive organised crime of a core client base. This would render illegal heroin trafficking unprofitable and spare future generations addiction.

Cannabis is demonstrably safer than alcohol and should be taxed and regulated like alcohol, only without the ubiquitous advertising. Separating the hard and soft drug markets is critical. As long as organised crime controls cannabis distribution, consumers will continue to come into contact with sellers of addictive drugs like cocaine. This "gateway" is a direct result of cannabis prohibition.

Robert Sharpe

Policy analyst

Common Sense for Drug Policy

Washington, DC

Congratulations on your editorial on the rethink of our drug policy but your final paragraph is far too weak. It should state that prohibition has totally failed and it is now time to switch to a policy of decriminalisation.

Brian O'Neill

Nottingham

As an occasional user of "soft" drugs in the 1970s, I have some very limited experience of what it's all about, but thankfully I have never been anywhere near the violence and corruption endemic in the supply chain.

Maria Lucia Karam's commentary on drug policy ("This war has failed totally, I've seen the carnage it causes") nearly brought me to tears. Her incisive views should be required reading for all politicians, but more than that, her piece should be the foundation for future global policy.

Neil Shillito

Norwich