An international commission of medical experts is calling for global drug decriminalisation, arguing that current policies lead to violence, deaths and the spread of disease, harming health and human rights.

The commission, set up by the Lancet medical journal and Johns Hopkins University in the United States, finds that tough drugs laws have caused misery, failed to curb drug use, fuelled violent crime and spread the epidemics of HIV and hepatitis C through unsafe injecting.

Publishing its report on the eve of a special session of the United Nations devoted to illegal narcotics, it urges a complete reversal of the repressive policies imposed by most governments.

“The goal of prohibiting all use, possession, production, and trafficking of illicit drugs is the basis of many of our national drug laws, but these policies are based on ideas about drug use and drug dependence that are not scientifically grounded,” says Dr Chris Beyrer of the Johns Hopkins Bloomberg School of Public Health, a member of the commission.

“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.”

The commission calls on the UN to back decriminalisation of minor, non-violent drug offences involving the use, possession and sale of small quantities. Military force against drug networks should be phased out, it says, and policing should be better targeted on the most violent armed criminals.

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Among its other recommendations are:

Minimise prison sentences for women involved in non-violent crimes who are often exploited as drug “mules”.

Move gradually towards legal, regulated drug markets which are “not politically possible in the short term in some places” although they predict more countries and US states will move that way, “a direction we endorse”.

Ensure easy access to clean needles, oral drugs such as methadone to reduce injecting and naloxene, the antidote to overdoses.

Stop aerial spraying of drug crops with toxic pesticides.

The commission comprises doctors, scientists and health and human rights experts from around the world. It is jointly chaired by Prof Adeeba Kamarulzaman from the University of Malaya and Prof Michel Kazatchkine, the UN special envoy for HIV/Aids in eastern Europe and central Asia.



Its report says scientific evidence on repressive drug policies is wanting. The last UN special session on drug use was in 1998, under the slogan, “a drug-free world – we can do it”. It backed a total clampdown, urging governments to eliminate drugs through bans on use, possession, production and trafficking.

The commission says that has not worked and that the casualties of that approach have been huge. The decision of the Calderón government in Mexico in 2006 to use the military in civilian areas to fight drug traffickers “ushered in an epidemic of violence in many parts of the country that also spilled into Central America”, says the report. “The increase in homicides in Mexico since 2006 is virtually unprecedented in a country not formally at war. It was so great in some parts of the country that it contributed to a reduction in the country’s projected life expectancy.”

Prohibitionist drug policies have had serious adverse consequences in the US, too. “The USA is perhaps the best documented but not the only country with clear racial biases in policing, arrests, and sentencing,” the commissioners write.

“In the USA in 2014, African American men were more than five times more likely than white people to be incarcerated for drug offences in their lifetime, although there is no significant difference in rates of drug use among these populations. The impact of this bias on communities of people of colour is inter-generational and socially and economically devastating.”

The commission cites examples of countries and US states that have moved down the decriminalisation road. “Countries such as Portugal and the Czech Republic decriminalised minor drug offences years ago, with significant financial savings, less incarceration, significant public health benefits, and no significant increase in drug use,” says the report.

“Decriminalisation of minor offences along with scaling up low-threshold HIV prevention services enabled Portugal to control an explosive, unsafe injection-linked HIV epidemic, and probably prevented one from happening in the Czech Republic.”

Beyrer told the Guardian the commission was “cautiously optimistic” that it would have an impact on the UN meeting, although it was aware of forcible opposition there to decriminalisation. “There certainly are a number of countries and some powerful countries like the Russian Federation that are vigorously opposed to any reform of current drug regimes and they will do anything they can to influence UNGASS [the UN special session],” he said.

“UNGASS is going to be a real struggle but there are a number of governments and civil society organisations that are really seeing the need for change.” In the US, the issue of overdose on prescription opioid medicines has become part of the presidential contest, he pointed out. “I think this is a moment. It is a once-in-a-generation opportunity,” said Beyrer.

At a release of the paper in New York, researcher Joanne Csete of Columbia University said she believed that US actor Philip Seymour Hoffman, who died of a heroin overdose, “would be alive today” were it not for regressive drug policies that she said made safe opioid maintenance almost impossible to obtain.

“Our report is about political choices,” she said. “The failure to invest in programmes that can help people always inject with sterile equipment is a political choice,” she said. “We’re dealing with a war on drugs … These policies have their roots in a racist and reactionary calculation.”

Prof Carl Hart, a research psychologist also at Columbia University who is well-known for activism against the war on drugs, echoed Csete’s comments. “One in three black males can expect to spend some time in prison,” Hart said. “I have three sons, one has spent time in prisons, and in part because we have vilified drugs, and [convinced the public] that drug users deserve that kind of punishment. So I can’t be silent this is personal.”

In Britain, the Home Office said drugs were illegal when there was scientific evidence they were harmful to health and society. A spokesman said that the approach was to enforce the existing law, prevent usage and help addicts recover. He added: “There are promising signs this approach is working, with a downward trend in drug use over the last decade and more people recovering from dependency now than in 2009/10. Decriminalising drugs would not eliminate the crime committed by their illicit trade, nor would it address the harms and destruction associated with drug dependence.”

Norman Lamb, a former British government minister and Liberal Democrat MP, said that he supported the Lancet commission’s findings: “The war on drugs has failed and it is Liberal Democrat policy to decriminalise the personal possession and use of all drugs, and introduce a regulated, legalised market for cannabis. Drug use should be treated as a health issue, not as a criminal issue.”