Intended for healthcare professionals


What would an evidence based drug policy be like?

BMJ 2014; 349 doi: (Published 09 December 2014) Cite this as: BMJ 2014;349:g7493
  1. Nicola Singleton, visiting researcher,
  2. John Strang, professor
  1. 1 National Addiction Centre (Institute of Psychiatry and The Maudsley), King’s College London, London SE5 8AF, UK
  1. Correspondence to: N Singleton nicolasingleton22{at}

Policy must move beyond evidence based to evidence infused to produce public good

In their foreword to the UK Home Office’s comparison of drug policies in various countries, government ministers stated that “the UK will continue to advocate a balanced, evidence-based approach to the misuse of drugs internationally.”1 In a subsequent Commons debate there was cross party support for the motion that “this House . . . believes that an evidence-based approach is required in order for . . . the Government to pursue the most effective drugs policy.”2 This flurry of attention raises the question: what would an evidence-based drug policy look like?

Although the prohibitionist legislative framework is the main focus of calls for reform, it is just one element of policy. Most countries have drug policies that include activities to reduce the demand for drugs, the harms associated with their use, and their supply. Evidence-based policy suggests a neat menu of well evidenced interventions from which a government can select the right mix for its circumstances. However, in common with many areas of social policy, drug use is multifaceted and “what works” is rarely clear cut and often contested. Both the nature and patterns of use, and the responses to these, vary between countries and over time; the interventions …

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