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International drug policy: at a crossroads or a dead-end?

Bales of cocaine on the deck of a US Coast Guard Ship
In 2014, US Coast Guard vessels seized four tons of cocaine and other drugs in what was then considered a “big” bust. Seizures have continued to climb, only to be outstripped by production. Connie Terrell/US Coast Guard

The international drug control regime was established more than a century ago, yet rarely has the issue received as much attention as it has since the 2010s. With the legalisation of cannabis in the Americas, the opioid-driven overdose crisis in the United States, the peace agreement in Colombia, the brutal “war on drugs” of Philippine president Rodrigo Duterte, and the adoption of a new political declaration at a UN special session, drug policy has often taken a front seat in national and international policy debates.

Despite the intense debates, the outcomes are meagre: problematic and recreational consumption continues to rise (with 23% increase in consumption in a decade, trafficking and gang violence worsen, and production of both natural and synthetic drugs is booming. Moreover, the current poly-crisis in the aftermath of a global pandemic, combining Russia’s invasion of Ukraine, economic frictions and climate change, make drug policy a low-priority area for policymakers and the public at large.

Immense challenges, wide impacts

The challenges are immense, and they directly influence public health, criminal justice, citizen safety and the integrity of the international drug-control regime.

First, harm-reduction services for overdoses and HIV prevention are caught in the battle over drug-control reform. Most people who inject drugs live in developing countries, yet harm-reduction funding has fallen to a mere 5% of what’s needed globally – against 10% of what was needed a decade ago. Access to pain relief is not much better and remains extremely unequal, with patients receiving morphine in high-income countries accessing 47g compared to 0,01g per year in the poorest ones.

Second, research on the medicinal and wellbeing benefits of cannabis or psychedelics has been attracting attention. These industries and their development are pushing the limits of the international drug control regime, which is concerned with the strict limitation of access to scheduled substances for legitimate medical use and scientific research, and the strict prohibition of access or production for any other markets or uses.

The International Narcotics Control Board, which holds countries accountable on their compliance with international drug law and certifies international trade in controlled medicines, is preparing to set limits and standards in the medical use of cannabis, attempting to regulate trade and any of the cannabis industry’s future global prospects.

Third, the criminalisation of drug use is still a contentious issue globally. It’s intended to reduce demand for drugs, but the end result is often increased incarceration and pre-trial detention rates and their racial biases. Nearly 30 countries in addition to state governments have adopted decriminalisation plans or reductions in criminal liability for drug use, yet criminalisation is still widely used as a deterrent. People who use drugs are still considered to engage in a criminal activity in the vast majority of countries around the world.

Finally, legalisation can seem like a pragmatic and actionable solution, but it requires a collaborative effort between stakeholders. Canada or some US states have permitted access to non-medical cannabis by establishing legal regulated markets, but as research has shown, regulation is not only rules set by governments that lead to punishment if broken. For example, who sets the standards in the supply chain – the state that establishes the norms, dispensaries with their specifications to farmers, or private standardisation labels? To avoid unintended consequences, regulation must be approached cautiously. It also needs to be understood that in an international framework with no questioning of the drug conventions that ban any non-medical use of psychoactive substances since the 1960s, it is highly unlikely to envisage such a debate on normative reform in the current geopolitical context.

Same old, same old

The sum of these drug control shortfalls, combined with the lack of implementation or indeed any consensual solution, makes it difficult to predict whether we could radically change the international drug control regime in the near future. Its dedicated budgets and implementation continue to focus on supply and demand reduction through repression. Affected populations are likely to continue being criminalised in most countries, and civil society will be left outside of the decision-making process.

What is certain is that in the current context, any meaningful reform is now far from a priority on public agendas. The 2010s, when concepts such as harm reduction and decriminalisation were advanced yet didn’t disrupt the status quo, are just a distant memory.

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