Intended for healthcare professionals

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

Re: Drugs should be legalised, regulated, and taxed

When it comes to this complex issue, it is important to be clear and specific about what we are discussing e.g. legalising vs. de-criminalising, Cannabis only vs. all drugs.

We need to look at the evidence and come to an “evidence based” conclusion, however, we need to take into consideration how each side interprets the evidence and indeed an informed public opinion.

Some evidence from the U.S. for example suggests that legalisation and subsequent “commercialisation” can lead to increased use of drugs at least in some populations (Hefei et al 2015, Martins et al 2016) while a recent systematic review and meta-analysis by Sarvet et al in 2018 did not find an association between these laws and marijuana use in adolescents in the US. A study by Rosalie et al concluded that this can vary according to the details of different laws.

The evidence from Portugal is more promising () where much less deaths from drug overdose have been reported since decriminalisation. However, we need to think about the difference between the 2 populations and also the availability of high potency Cannabis.

The Portuguese model is not only about "de-criminalisation", but more importantly, involves efforts from a public health perspective: harm reduction, cultural changes and targeting vulnerable populations. Some would argue the UK is already doing all of this but I think both sides of the argument can agree that more needs to be done.

Focusing on the public health aspects of the drug problem is a smart investment that should start by supporting the shrinking drug and alcohol services all over the country as well as a radical change in the social care system.

Competing interests: No competing interests

16 May 2018
Motaz Sonbol
Core Psychiatry Trainee
UK