Intended for healthcare professionals

Rapid response to:

Editor's Choice

Drugs should be legalised, regulated, and taxed

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2057 (Published 10 May 2018) Cite this as: BMJ 2018;361:k2057

Rapid Response:

Re: Drugs should be legalised, regulated, and taxed

We are very pleased that the BMJ have used this editorial to come out in support of meaningful drug reform. The trend of the medical establishment to do this is greatly welcomed and is an important step in viewing addiction as a medical and social problem rather than a criminal one. In the UK we have long adopted an evidence-based approach to medicine and the evidence on drug policy is clear; our current policy is harmful and does not work.

Regardless of your position in the drugs debate, the measures of a successful policy remain the same: decreased morbidity and mortality, fewer young people using drugs and more people accessing rehabilitation services and recovering from addiction. Prohibition impacts upon all these outcomes. Drug users are forced to adopt risky behaviours, due to limited knowledge and lack of control over the quality and quantity of the substance being taken. They are pushed into dangerous and criminal situations to fund their habits and are deterred from seeking help due to fear of criminalisation.

One of the founding principles of the NHS was to provide universal treatment to all those who need it. We have long recognised addiction as a mental health issue, however our laws discriminate against these patients and prevent clinicians treating them in the most effective manner. To resolve this, drug policy must be moved from the Home Office to the Department of Health and driven by evidence-based public health. After this happened Portugal in 2001, they have seen the control of an HIV epidemic, more drug users receiving treatment (doi:10.1111/j.1465-3362.2011.00383.x) and large reductions in the associated social costs (doi:10.1016/j.drugpo.2014.08.017). State control and regulation of compounds such as cannabis will allow control of potentially dangerous strains, limit use in young people and will provide valuable revenue to help fund addiction and rehabilitation services. Finally, the relaxation of legal status will allow the expansion of incredibly promising research into the medical uses of currently illegal substances such as the use of psilocybin for treatment-resistant depression (doi:10.1016/S2215-0366(16)30065-7).

As medical students nearing the end of our training, we have seen the harmful effects of drug taking and the difficulties in treating those who are often amongst the most vulnerable in society. We have also seen the extent of drug use in student populations and the risks associated with forcing this underground. We hope universities move away from threatened punitive measures, towards implementing support services and safe spaces with drug-testing facilities.

We are excited that a shift in the medical consensus is taking place and that during our careers we may see a shift in policy that would allow us to deliver the best treatment to those who need it most.

Competing interests: No competing interests

14 May 2018
Samuel Ensor
Medical Student
Jacob Bradshaw
Imperial College London
London