Intended for healthcare professionals

Observations War on Drugs

Reasons for drug policy reform: prohibition enables systemic human rights abuses and undermines public health

BMJ 2017; 356 doi: (Published 17 January 2017) Cite this as: BMJ 2017;356:i6586
  1. Dainius Pūras, UN special rapporteur on the right to health1 2,
  2. Julie Hannah, co-director2
  1. 1Centre for Child Psychiatry and Social Pediatrics, Vilnius University, Lithuania
  2. 2International Centre on Human Rights and Drug Policy, Human Rights Centre, University of Essex, Colchester, UK
  1. Correspondence to: J Hannah jhanna{at}

Harsh enforcement of prohibition undermines the right to health and fundamental dignity, write Dainius Pūras and Julie Hannah

Drug prohibition, including criminalisation to regulate the supply and demand of controlled substances, has had devastating effects on human rights and public health worldwide.

Prohibition as an international policy response gives rise to illicit drug markets governed by criminal networks and regulated by violence. The poor and marginalised communities in which illicit drugs are cultivated, transited, or sold are disproportionately affected. States have responded with increased law enforcement, escalating violence and further destabilising communities. Parallel violent pursuits both to protect and to topple illicit markets have been linked to large scale displacement, femicide, and an overall decrease in life expectancy, such as in Mexico.1

Mass incarceration to enforce prohibition has overburdened criminal justice systems and left countless people languishing in deplorable facilities in inhumane conditions around the world.2 Criminalisation of possession means that a fifth of …

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