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Rapid response to:

Editor's Choice

Drugs should be legalised, regulated, and taxed

BMJ 2018; 361 doi: (Published 10 May 2018) Cite this as: BMJ 2018;361:k2057

Rapid Response:

Re: Drugs should be legalised, regulated, and taxed. How does change like this happen, big bang, controlled legislation or creeping decriminalisation by stealth?

As outlined in this, and other recent reports and documents, change is increasingly supported from all sectors, not least the Colleges, the police and the public. Growing unease about the damage done by drugs and the potential for a better system has lead to fragmentation of international drugs policy and a era of experimentation in countries like the Netherlands, Uruguay and several US states on the basis that anything must be better than the present blind ideology of tougher restrictions for suppliers and the frankly hostile approach to drug takers. As the recent United Nations summit on drugs in 2016 showed, politicians are understandably reluctant to venture into areas fraught with complexities and without any prospect of a simple, risk free way forward. We are therefore left with the slow emergence of experimental changes and trials of local policy relaxation. Much of this shifting applies to cannabis and the UK's leading and ground breaking rescheduling of cannabis to reduce penalties, which was reversed within a few years, demonstrates the difficulty of formal relaxation of, in this case, penalties for possession of this drug, now returned to Class B in the Misuse of Drugs Act 1971.

Are we left then with a piecemeal process of change by trial and error without the formality of proper evaluation and funding of NHS services to cope with any unintended consquences? It would be far better to have a National and cross party truce on this important issue and the establishment of a Commission to explore the possibilities of a staged, controlled series of steps to arrive at a humane approach to drug users and an economically improved system for us all.

Competing interests: No competing interests

14 May 2018
Roy Robertson
Academic and General Practitioner
Usher Institute, University of Edinburgh
Muirhouse Medical Group, 1 Muirhouse Avenue, EH4 4PL