Below are the citation and extracts from an editorial in the current issue of The Lancet. As the editorial concludes: "What more will it take for policy makers to listen?"
CITATION: EDITORIAL| VOLUME 402, ISSUE 10416, P1941, NOVEMBER 25, 2023
Drug decriminalisation: grounding policy in evidence
The Lancet
Published: November 25, 2023 DOI:https://doi.org/10.1016/S0140-6736(23)02617-X
The Global Commission on Drug Policy's latest report, published ahead of World AIDS Day on Dec 1, describes decriminalisation of drug use as an essential precursor to ending HIV and viral hepatitis as public health threats. Since its formation in 2011 by political, economic, and cultural leaders, the Commission has advocated for decriminalisation as part of a rights-based approach to drug policy, rooted in scientific evidence and principles of public health, to minimise the harms arising from drug use... National drug policies largely remain punitive; they are polarised, simplified, and based more on ideology than evidence...
Decriminalisation alone is, of course, not sufficient... Portugal garnered international attention when, in the early 2000s, it decriminalised drugs as part of its progressive response to the growing use of injectable drugs and transmission of HIV and viral hepatitis in the country. The number of people using heroin fell from an estimated 100 000, in 2001, to 25 000, in 2017; fatal overdoses decreased by more than 85%, and new HIV diagnoses by more than 90%... Portugal's approach was not to simply decriminalise; it redefined addiction as an illness and provided extensive treatment and recovery support, moving people who use drugs away from the judicial system and towards professional care...
What has long been clear is that punitive approaches are both ineffective and harmful... Harm reduction strategies such as opioid-agonist treatments, sterile injecting equipment, safe injection centres, and psychosocial interventions do not, contrary to belief, promote drug use...
Bold and comprehensive reforms are needed to pursue health-oriented, rights-based drug decriminalisation policies. What more will it take for policy makers to listen?
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HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
