Drugs should be legalised, regulated, and taxed

Some numbers in this week’s journal bear reflection. The war on drugs costs each UK taxpayer an estimated £400 a year. The UK is now the world’s largest exporter of legal cannabis, yet recreational and medicinal use are criminalised. Scotland has the EU’s highest rate of drug related deaths, double that of 10 years ago. The global trade in illicit drugs is worth £236bn, but this money fuels organised crime and human misery. Why should it not instead fund public services?

A growing number of countries are taking a more enlightened route, say Jason Reed and Paul Whitehouse (doi:10.1136/bmj.k1999). In Portugal, where non-violent possession of drugs has been decriminalised, consumption hasn’t increased but drug related deaths have fallen considerably. In the Netherlands, the USA, and now Canada, regulated markets for the sale of cannabis generate substantial tax revenues.

Meanwhile, in the UK vast sums are spent on prosecuting individuals and trying vainly to interrupt the flow of drugs into cities, carried along “county lines” by vulnerable children. Reed and Whitehouse speak for the Law Enforcement Action Partnership, which calls for legalisation and regulation. They say that the money could instead be spent on quality control, education, treatment for drug users, and child protection. Revenues could be diverted from criminal gangs into government coffers.

When law enforcement officers call for drugs to be legalised, we have to listen. So too when doctors speak up. Last month the Royal College of Physicians took the important step of coming out in favour of decriminalisation, (doi:10.1136/bmj.k1832) joining the BMA, the Faculty of Public Health, and the Royal Society of Public Health in supporting drug policy reform (doi:10.1136/bmj.j3461.)

This is not about whether you think drugs are good or bad. It is an evidence based position entirely in line with the public health approach to violent crime. In their Editorial, John Middleton and Jonathan Shepherd say that the UK’s epidemic of gun and knife crime is in part due to the increased availability of fentanyl and crack cocaine (doi:10.1136/bmj.k1967). The UK government’s newly released Serious Violence Strategy acknowledges the link between drug prohibition and violence, but it proposes spending £40m on prohibition related policies. Reed and Whitehouse say it will do nothing to tackle drug related crime.

The BMJ is firmly behind efforts to legalise, regulate, and tax the sale of drugs for recreational and medicinal use. This is an issue on which doctors can and should make their voices heard.