Should we decriminalise or legalise illicit drugs?

We should legalise cannabis, and decriminalise harder drugs

Psychoactive drugs have been grown and used throughout human history. Opium and ‘laudanum’ (opium and alcohol), cocaine and ‘cocaine wine’ were popular in the UK and the USA in the 1800s but increasing use and adverse social effects raised concerns. The US 1914 Harrison Narcotics Tax Act restricted the manufacture and distribution of opiates and coca derivatives – just a few years before alcohol prohibition – as did the UK’s 1920 Dangerous Drugs Act.[1,2]

The 1961 United Nations (UN) International Single Convention on Narcotic Drugs required all member countries to prohibit production, supply and recreational use of narcotic drugs except under licence for specific purposes, such as medical treatment and research. This and the (arguably drug-fuelled) social unrest of the 1960s led to the United States’ Controlled Substances Act of 1970 and the United Kingdom’s Misuse of Drugs Act 1971. Different nations have however drawn different conclusions as to whether the UN treaty requires criminalization of drug possession for personal use.[1,2]

This ‘War on Drugs’ over the past 50 years has however clearly not worked. Supply and demand, use and harms, continue to rise unabated [3]. Since 1990, illegal drug prices have generally decreased while drug purity has generally increased [4], and the global burden of drug use disorders, especially opioid dependence, has increased [5]. It is highest in relatively wealthy countries – the UK, USA, Australia and Russia – which also happen to have relatively strict drug laws (6).

The pro’s and con’s of legalisation

Legalising narcotic drugs would allow governments to exert greater control over production and consumption, and to generate tax income on both. A Harvard economist recently estimated that the legalization of drugs in the USA would bring annual savings on enforcement and incarceration of about $41 billion, and also raise $47 billion in tax.[8] It might also generate safer products and reduce funding of organised crime around the world.

The biggest risks of decriminalisation or legalisation is that use might increase. Perhaps the very fact that some drugs are illegal puts some people off taking them. One could make the case that the rising use of ‘legal highs’ and ‘the prescription opioid crisis’ show that legal drugs can be just as open to abuse as illegal ones. However, the available evidence suggests that the decriminalisation of cannabis has not increased use in the Netherlands or the USA,[3,7] and legalising all drugs in Portugal appears to have had a number of benefits including reduced use.[3,7,9]

It is however not clear that legalising drugs would have the same results in other countries. As has been argued elsewhere,[10] international drug treaties now need to be altered to allow for policy experiments across nations. A globally agreed initiative could free up politicians to make the brave decisions required to decriminalise or legalise illegal drugs, and potentially improve health and save money.


[1] Cocaine. Wikipedia. (accessed 30.09.15)

[2] Opium. Wikipedia. 30.09.15)


[4] Dan Werb et al. The temporal relationship between drug supply indicators: an audit of international government surveillance systems. BMJ Open 2013;3:e003077 doi:10.1136/bmjopen-2013-003077 .

[5] Degenhardt L, et al. Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. Lancet. 2013 Nov 9;382(9904):1564-74.

[6] Osborn A. Russia declares “total war” on drugs to tackle 100 000 deaths a year. British Medical Journal, Vol. 343, No. 7814 (9 July 2011), p. 65.

[7] Home Office. Drugs: international comparators. 2014.

[8] War on drugs. Wikipedia.

[9] Lamb C. Portugal’s ‘crazy’ drugs fix proves a hit. The Sunday Times 06.09.15 p.32

[10] Farrell M. Drug legalisation. BMJ. 2014 Aug 21;349:g5233.

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