WARO N DR UGSR E P O RT O F TH E
G LO B A L CO MMIS S IONON D R U G P O LICY
JUN E 2011

REPOR T OF THE
GLOBAL COMMISSIONON DRUG POLICYC OMMISSIONERSAsma Jahangir, human rights activist, former
UN Special Rapporteur on Arbitrary, Extrajudicial andSummary Executions, Pakistan
Carlos Fuentes, writer and public intellectual, Mexico
César Gaviria, former President of Colombia
Ernesto Zedillo, former President of Mexico

To learn more about the Commission, visit:www.globalcommissionondrugs.org
Or email: declaration@globalcommissionondrugs.org

Fernando Henrique Cardoso, former President ofBrazil (chair)
George Papandreou, Prime Minister of Greece
George P. Shultz, former Secretary of State, United States(honorary chair)
Javier Solana, former European Union High Representative
for the Common Foreign and Security Policy, SpainJohn Whitehead, banker and civil servant, chair of theWorld Trade Center Memorial Foundation, United States
Kofi Annan, former Secretary General of the United
Nations, Ghana
Louise Arbour, former UN High Commissioner for Human
Rights, President of the International Crisis Group, Canada
Maria Cattaui, Petroplus Holdings Board member,
former Secretary-General of the International Chamber ofCommerce, Switzerland
Mario Vargas Llosa, writer and public intellectual, Peru
Marion Caspers-Merk, former State Secretary at theGerman Federal Ministry of HealthMichel Kazatchkine, executive director of the Global Fundto Fight AIDS, Tuberculosis and Malaria, France
Paul Volcker, former Chairman of the United States
Federal Reserve and of the Economic Recovery Board
Richard Branson, entrepreneur, advocate forsocial causes, founder of the Virgin Group, co-founderof The Elders, United Kingdom
Ruth Dreifuss, former President of Switzerland andMinister of Home Affairs
Thorvald Stoltenberg, former Minister of Foreign Affairs
and UN High Commissioner for Refugees, Norway

E XE CUTIVE SUMMARY

The global war on drugs has failed, withdevastating consequences for individuals
and societies around the world. Fifty years
after the initiation of the UN Single
Convention on Narcotic Drugs, and40 years after President Nixon launched
the US government’s war on drugs,
fundamental reforms in national and global
drug control policies are urgently needed.

Our principles and recommendations canbe summarized as follows:

Vast expenditures on criminalization andrepressive measures directed at producers,
traffickers and consumers of illegal drugs
have clearly failed to effectively curtail
supply or consumption. Apparent victories
in eliminating one source or trafficking
organization are negated almost instantly
by the emergence of other sources andtraffickers. Repressive efforts directed at
consumers impede public health measures
to reduce HIV/AIDS, overdose fatalities
and other harmful consequences ofdrug use. Government expenditures on
futile supply reduction strategies andincarceration displace more cost-effective
and evidence-based investments indemand and harm reduction.

Encourage experimentation by governmentswith models of legal regulation of drugs toundermine the power of organized crimeand safeguard the health and security of
their citizens. This recommendation applies
especially to cannabis, but we also encourageother experiments in decriminalization andlegal regulation that can accomplish theseobjectives and provide models for others.

2

Global Commission on Drug Policy

End the criminalization, marginalizationand stigmatization of people who use drugs
but who do no harm to others. Challenge
rather than reinforce common misconceptions
about drug markets, drug use anddrug dependence.

Offer health and treatment services to thosein need. Ensure that a variety of treatment
modalities are available, including not justmethadone and buprenorphine treatment but
also the heroin-assisted treatment programs
that have proven successful in many European
countries and Canada. Implement syringe
access and other harm reduction measuresthat have proven effective in reducing
transmission of HIV and other blood-borne
infections as well as fatal overdoses. Respect
the human rights of people who use drugs.
Abolish abusive practices carried out in thename of treatment – such as forced detention,forced labor, and physical or psychologicalabuse – that contravene human rights
standards and norms or that remove theright to self-determination.
Apply much the same principles andpolicies stated above to people involvedin the lower ends of illegal drug markets,
such as farmers, couriers and petty sellers.
Many are themselves victims of violence
and intimidation or are drug dependent.
Arresting and incarcerating tens of millionsof these people in recent decades has filled
prisons and destroyed lives and families
without reducing the availability of illicit
drugs or the power of criminal organizations.
There appears to be almost no limit to
the number of people willing to engage insuch activities to better their lives, provide
for their families, or otherwise escapepoverty. Drug control resources are better
directed elsewhere.
Invest in activities that can both prevent
young people from taking drugs in thefirst place and also prevent those who douse drugs from developing more serious
problems. Eschew simplistic ‘just say no’messages and ‘zero tolerance’ policies
in favor of educational efforts groundedin credible information and prevention
programs that focus on social skills and peer
influences. The most successful prevention
efforts may be those targeted at specificat-risk groups.

Focus repressive actions on violent
criminal organizations, but do so in waysthat undermine their power and reachwhile prioritizing the reduction of violence
and intimidation. Law enforcement
efforts should focus not on reducing drug
markets per se but rather on reducing theirharms to individuals, communities andnational security.
Begin the transformation of the global
drug prohibition regime. Replace drug
policies and strategies driven by ideology
and political convenience with fiscally
responsible policies and strategies
grounded in science, health, security andhuman rights – and adopt appropriate
criteria for their evaluation. Review thescheduling of drugs that has resulted
in obvious anomalies like the flawed
categorization of cannabis, coca leaf and
MDMA. Ensure that the international
conventions are interpreted and/or revised
to accommodate robust experimentation
with harm reduction, decriminalization andlegal regulatory policies.
Break the taboo on debate and reform.
The time for action is now.

Global Commission on Drug Policy

3

INTR ODUC T IO N

U N I TE D N ATION S E STIMATE S O F ANNUA L DRUG
CO N S U MPTION, 1998 TO 2008
Opiates

CocaineCannabis

1998

12.9 million

13.4 million

147.4 million

2008

17.35 million

17 million

160 million% Increase

34.5%

27%

8.5%

The global war on drugs has failed. When the United
Nations Single Convention on Narcotic Drugs came into
being 50 years ago, and when President Nixon launched the
US government’s war on drugs 40 years ago, policymakers
believed that harsh law enforcement action against those
involved in drug production, distribution and use would
lead to an ever-diminishing market in controlled drugs
such as heroin, cocaine and cannabis, and the eventual
achievement of a ‘drug free world’. In practice, the global
scale of illegal drug markets – largely controlled byorganized crime – has grown dramatically over this period.
While accurate estimates of global consumption across theentire 50-year period are not available, an analysis of thelast 10 years alone1,2,3,4 shows a large and growing market.
(See chart above.)

In spite of the increasing evidence that current policies are
not achieving their objectives, most policymaking bodies
at the national and international level have tended to avoid
open scrutiny or debate on alternatives.

Note on Methodology:

We also drew on the conclusions of a study written by eminent researchersPeter Reuter and Franz Trautmann2, and commissioned by the European
Union, that examined global trends across this period. They concluded:This lack of leadership on drug policy has prompted theestablishment of our Commission, and leads us to our viewthat the time is now right for a serious, comprehensive
and wide-ranging review of strategies to respond to thedrug phenomenon. The starting point for this review is
the recognition of the global drug problem as a set ofinterlinked health and social challenges to be managed,
rather than a war to be won.
Commission members have agreed on four core principles
that should guide national and international drug policies
and strategies, and have made eleven recommendations
for action.

The data in table 1 has been obtained from the following publications of theUnited Nations Office on Drugs and Crime:“The global drug problem clearly did not get any better during the UNGASS
period. For some countries (mostly rich ones) the problem declined but forothers (mostly developing or transitional) it worsened, in some cases sharply
and substantially...In aggregate, given the limitations of the data, a fairjudgment is that the problem became somewhat more severe.”

UNODC (2010) World Drug Report 2010 http://www.unodc.org/unodc/en/
data-and-analysis/WDR-2010.html
ODCCP (2002) Studies on Drugs and Crime: Global Illicit Drug Trends 2002
http://www.unodc.org/unodc/data-and-analysis/WDR.html

Neither our estimates, nor those of the UNODC, can be treated as
In calculating the estimates of global prevalence for 2008, we used a midunquestionable – but neither contradict our central conclusion that there
range figure from the very wide range of possibilities estimated by UNODC in
is a ‘large and growing market’. After 10 years of a global campaign
the World Drug Report 2010. Such a wide range of estimation indicates highto ‘eradicate or significantly reduce’ the scale of global drug markets,
levels of uncertainty regarding the data. The UNODC ‘best estimate’ is, in(as announced in the Political Declaration adopted at the 20th Special
its own words, “in most cases...the mid-point between the upper and lower
Session of the United Nations General Assembly on Countering the World
range estimates.”1 In this instance UNODC chose to publish a best estimate
Drug Problem, June 1998) we have to conclude that consideration of newlower than the mid-point. As the precise methodological reasons for making
strategies is necessary.
this choice are not made public, and taking into account the downwards
1pressures on the estimates submitted by governments to the UNODC, we
http://www.unodc.org/documents/data-and-analysis/WDR2010/
believe that the use of a mid-point figure is justified.
WDR2010methodology.pdf
2

4

Global Commission on Drug PolicyPeter Reuter and Franz Trautmann, Eds (2009) A Report on Global Illicit
Drug Markets 1998-2007 European Commission

P R I NCI P L ES

1. Drug policies must be based on solid empirical andscientific evidence. The primary measure of successshould be the reduction of harm to the health,security and welfare of individuals and society.
In the 50 years since the United Nations initiated a truly
global drug prohibition system, we have learned muchabout the nature and patterns of drug production,
distribution, use and dependence, and the effectivenessof our attempts to reduce these problems. It might havebeen understandable that the architects of the system
would place faith in the concept of eradicating drug
production and use (in the light of the limited evidence
available at the time). There is no excuse, however, forignoring the evidence and experience accumulated
since then. Drug policies and strategies at all levels too
often continue to be driven by ideological perspectives,or political convenience, and pay too little attention
to the complexities of the drug market, drug use anddrug addiction.
Effective policymaking requires a clear articulation of thepolicy’s objectives. The 1961 UN Single Convention on
Narcotic Drugs made it clear that the ultimate objectiveof the system was the improvement of the ‘health andwelfare of mankind’.
This reminds us that drug policies were initiallydeveloped and implemented in the hope of achieving
outcomes in terms of a reduction in harms to individuals
and society – less crime, better health, and more
economic and social development. However, we haveprimarily been measuring our success in the war on
drugs by entirely different measures – those that reporton processes, such as the number of arrests, theamounts seized, or the harshness of punishments. These
indicators may tell us how tough we are being, but they
do not tell us how successful we are in improving the‘health and welfare of mankind’.

2. Drug policies must be based on human rights
and public health principles. We should end thestigmatization and marginalization of people who
use certain drugs and those involved in the lower
levels of cultivation, production and distribution,and treat people dependent on drugs as patients,
not criminals.
Certain fundamental principles underpin all aspects ofnational and international policy. These are enshrinedin the Universal Declaration of Human Rights and many
international treaties that have followed. Of particular
relevance to drug policy are the rights to life, to health,to due process and a fair trial, to be free from tortureor cruel, inhuman or degrading treatment, from slavery,
and from discrimination. These rights are inalienable,
and commitment to them takes precedence over otherinternational agreements, including the drug control
conventions. As the UN High Commissioner for Human
Rights, Navanethem Pillay, has stated, “Individuals
who use drugs do not forfeit their human rights. Toooften, drug users suffer discrimination, are forced toaccept treatment, marginalized and often harmed byapproaches which over-emphasize criminalization andpunishment while under-emphasizing harm reduction
and respect for human rights.”5
A number of well-established and proven publichealth measures6,7 (generally referred to as harm
reduction, an approach that includes syringe access andtreatment using the proven medications methadone orbuprenorphine) can minimize the risk of drug overdose
deaths and the transmission of HIV and other bloodborne infections.8 However, governments often do not
fully implement these interventions, concerned that by
improving the health of people who use drugs, they
are undermining a ‘tough on drugs’ message. This is
illogical – sacrificing the health and welfare of one groupof citizens when effective health protection measures areavailable is unacceptable, and increases the risks facedby the wider community.

Global Commission on Drug Policy

5

P R I NC IP L ES
(Continued)

IMPA C T OF DR UG POLICIE S
O N R E CE N T H IV PR E VALE N CE
A M O N G PE OPLE WH O
IN JE C T DR UGS 9Countries that implemented harm reduction and publichealth strategies early have experienced consistently low
rates of HIV transmission among people who inject drugs.
Similarly, countries that responded to increasing HIV
prevalence among drug users by introducing harm reduction
programs have been successful in containing and reversing
the further spread of HIV. On the other hand, many countries
that have relied on repression and deterrence as a response
to increasing rates of drug-related HIV transmission are
experiencing the highest rates of HIV among drug using
populations.10,11,12

Sample of countries that have consistently
implemented comprehensive harm reduction
strategies:
UK
Switzerland
Germany
Australia
0
5
10
15
20
25
30
35
% HIV prevalence among people who inject drugs

40

45

Sample of countries that have introduced harm
reduction strategies partially, or late in the
progress of the epidemic:
USA
Portugal
Malaysia
France
0
5
10
15
20
25
30
35
% HIV prevalence among people who inject drugs

40

45

Sample of countries that have consistently
resisted large scale implementation of harm
reduction strategies, despite the presence ofdrug injecting and sharing:
ThailandRussia
0
5
10
15
20
25
30
35
% HIV prevalence among people who inject drugs

6

40

45

Global Commission on Drug Policy

An indiscriminate approach to ‘drug trafficking’ is similarly
problematic. Many people taking part in the drug market arethemselves the victims of violence and intimidation, or are
dependent on drugs. An example of this phenomenon are
the drug ‘mules’ who take the most visible and risky roles inthe supply and delivery chain. Unlike those in charge of drugtrafficking organizations, these individuals do not usually havean extensive and violent criminal history, and some engage
in the drug trade primarily to get money for their own drug
dependence. We should not treat all those arrested for
trafficking as equally culpable – many are coerced into theiractions, or are driven to desperate measures through theirown addiction or economic situation. It is not appropriate topunish such individuals in the same way as the members ofviolent organized crime groups who control the market.
Finally, many countries still react to people dependent on
drugs with punishment and stigmatization. In reality, drug
dependence is a complex health condition that has a mixtureof causes – social, psychological and physical (including, forexample, harsh living conditions, or a history of personal
trauma or emotional problems). Trying to manage thiscomplex condition through punishment is ineffective – muchgreater success can be achieved by providing a range ofevidence-based drug treatment services. Countries that havetreated citizens dependent on drugs as patients in need oftreatment, instead of criminals deserving of punishment, havedemonstrated extremely positive results in crime reduction,
health improvement, and overcoming dependence.

PAT IE N TS NOT CR IMINALS:
A MO R E H UMANE AND E FF E CT IVE A P P RO A C H

Case Study One: Switzerland13

Case Study Two: United Kingdom15

In response to severe and highly visible drug
problems that developed across the country in
the 1980s, Switzerland implemented a new set ofpolicies and programs (including heroin substitution
programs) based on public health instead ofcriminalization. The consistent implementationof this policy has led to an overall reduction in
the number of people addicted to heroin as well
as a range of other benefits. A key study14
concluded that:

Research carried out in the UK into the effectsof their policy of diversion from custody into
treatment programs clearly demonstrated a
reduction in offending following treatment
intervention. In addition to self-reports, theresearchers in this case also referred to police
criminal records data. The research showsthat the numbers of charges brought against
1,476 drug users in the years before and after
entering treatment reduced by 48 percent.

“Heroin substitution targeted hard-core
problematic users (heavy consumers) – assumingthat 3,000 addicts represent 10 percent to15 percent of Switzerland’s heroin users that may
account for 30 percent to 60 percent of the demandfor heroin on illegal markets. Heavily engaged inboth drug dealing and other forms of crime, theyalso served as a link between wholesalers and users.
As these hard-core users found a steady, legalmeans for their addiction, their illicit drug use was
reduced as well as their need to deal in heroin
and engage in other criminal activities.

Case Study Three: The Netherlands16,17,18

The heroin substitution program had three effects
on the drug market:• It substantially reduced the consumption among
the heaviest users, and this reduction in demandaffected the viability of the market. (For example,
the number of new addicts registered in Zurich
in 1990 was 850. By 2005, the number had
fallen to 150.)•  It reduced levels of other criminal activity
associated with the market. (For example, there
was a 90 percent reduction in property crimes
committed by participants in the program.)•  By removing local addicts and dealers, Swiss casual
users found it difficult to make contact with sellers.”

Of all EU-15 countries, the percentage of people
who inject heroin is the lowest in the Netherlands
and there is no new influx of problematic users.
Heroin has lost its appeal to the mainstream youth
and is considered a ‘dead-end street drug’.
The number of problematic heroin users has
dropped significantly and the average age of users
has risen considerably. Large-scale, low-threshold
drug treatment and harm reduction services
include syringe access and the prescription of
methadone and heroin under strict conditions.
Medically prescribed heroin has been foundin the Netherlands to reduce petty crime andpublic nuisance, and to have positive effects on
the health of people struggling with addiction.
In 2001, the estimated number of people in the
Netherlands dependent on heroin was 28-30,000.
By 2008, that number had fallen to 18,000.
The Dutch population of opiate users is in theprocess of aging – the proportion of young
opiate users (aged 15-29) receiving treatment for
addiction has also declined.

Global Commission on Drug Policy

9P R I NCI P L ES
(Continued)

3. The development and implementation of drug
policies should be a global shared responsibility,
but also needs to take into consideration diverse
political, social and cultural realities. Policies should
respect the rights and needs of people affectedby production, trafficking and consumption, as
explicitly acknowledged in the 1988 Convention
on Drug Trafficking.
The UN drug control system is built on the idea thatall governments should work together to tackle drug
markets and related problems. This is a reasonable
starting point, and there is certainly a responsibility to
be shared between producing, transit and consuming
countries (although the distinction is increasingly blurred,as many countries now experience elements of all three).
However, the idea of shared responsibility has too often
become a straitjacket that inhibits policy development
and experimentation. The UN (through the International
Narcotics Control Board), and in particular the US(notably through its ‘certification’ process), have worked
strenuously over the last 50 years to ensure that all
countries adopt the same rigid approach to drug policy– the same laws, and the same tough approach to theirenforcement. As national governments have become
more aware of the complexities of the problems, andoptions for policy responses in their own territories,
many have opted to use the flexibilities within theConventions to try new strategies and programs, such as
decriminalization initiatives or harm reduction programs.
When these involve a more tolerant approach to druguse, governments have faced international diplomaticpressure to ‘protect the integrity of the Conventions’,
even when the policy is legal, successful and supported
in the country.

8

Global Commission on Drug Policy

A current example of this process (what may be describedas ‘drug control imperialism’), can be observed with theproposal by the Bolivian government to remove thepractice of coca leaf chewing from the sections of the1961 Convention that prohibit all non-medical uses.
Despite the fact that successive studies have shown19 thatthe indigenous practice of coca leaf chewing is associatedwith none of the harms of international cocaine markets,and that a clear majority of the Bolivian population (andneighboring countries) support this change, many of therich ‘cocaine consumer’ countries (led by the US) haveformally objected to the amendment.20
The idea that the international drug control system is
immutable, and that any amendment – however reasonable
or slight – is a threat to the integrity of the entire system,
is short-sighted. As with all multilateral agreements, thedrug conventions need to be subject to constant review
and modernization in light of changing and variable
circumstances. Specifically, national governments must
be enabled to exercise the freedom to experiment withresponses more suited to their circumstances. This analysis
and exchange of experiences is a crucial element of theprocess of learning about the relative effectiveness ofdifferent approaches, but the belief that we all need to haveexactly the same laws, restrictions and programs has been
an unhelpful restriction.

U N I N TE N DE D CONS E QU E N CES
The implementation of the war on drugs has generated
widespread negative consequences for societies in
producer, transit and consumer countries. These
negative consequences were well summarized by theformer Executive Director of the United Nations Officeon Drugs and Crime, Antonio Maria Costa, as falling into
five broad categories:
1. The growth of a ‘huge criminal black market’, financedby the risk-escalated profits of supplying international
demand for illicit drugs.
2. Extensive policy displacement, the result of using scarce
resources to fund a vast law enforcement effort intended
to address this criminal market.
3. Geographical displacement, often known as ‘the balloon
effect’, whereby drug production shifts location to avoid
the attentions of law enforcement.
4. Substance displacement, or the movement of consumers
to new substances when their previous drug of choicebecomes difficult to obtain, for instance through law
enforcement pressure.
5. The perception and treatment of drug users, who arestigmatized, marginalized and excluded.21

4. Drug policies must be pursued in a comprehensive
manner, involving families, schools, public healthspecialists, development practitioners and civil society
leaders, in partnership with law enforcement agencies
and other relevant governmental bodies.
With their strong focus on law enforcement andpunishment, it is not surprising that the leading
institutions in the implementation of the drug control
system have been the police, border control and military
authorities directed by Ministries of Justice, Security
or Interior. At the multilateral level, regional or United
Nations structures are also dominated by these interests.

Although governments have increasingly recognized that
law enforcement strategies for drug control need to be
integrated into a broader approach with social and publichealth programs, the structures for policymaking, budget
allocation, and implementation have not modernized at
the same pace.
These institutional dynamics obstruct objective andevidence-based policymaking. This is more thana theoretical problem – repeated studies22,23 havedemonstrated that governments achieve much greater
financial and social benefit for their communities byinvesting in health and social programs, rather thaninvesting in supply reduction and law enforcement activities.
However, in most countries, the vast majority of available
resources are spent on the enforcement of drug laws andthe punishment of people who use drugs.24
The lack of coherence is even more marked at theUnited Nations. The development of the global drug
control regime involved the creation of three bodies tooversee the implementation of the conventions – the UN
Office on Drugs and Crime (UNODC), the International
Narcotics Control Board (INCB), and the Commission on
Narcotic Drugs (CND). This structure is premised on thenotion that international drug control is primarily a fightagainst crime and criminals. Unsurprisingly, there is abuilt-in vested interest in maintaining the law enforcement
focus and the senior decisionmakers in these bodies havetraditionally been most familiar with this framework.
Now that the nature of the drug policy challenge haschanged, the institutions must follow. Global drug policy
should be created from the shared strategies of allinterested multilateral agencies – UNODC of course, butalso UNAIDS, WHO, UNDP, UNICEF, UN Women, theWorld Bank, and the Office of the High Commissioner on
Human Rights. The marginalization of the World HealthOrganization is particularly worrisome given the fact thatit has been given a specific mandate under the drug
control treaties.

Global Commission on Drug Policy

9

R E COMMEN D AT IO NS

1. Break the taboo. Pursue an open debate
and promote policies that effectively reduce
consumption, and that prevent and reduce harms
related to drug use and drug control policies.
Increase investment in research and analysis into
the impact of different policies and programs.25
Political leaders and public figures should have thecourage to articulate publicly what many of themacknowledge privately: that the evidence
overwhelmingly demonstrates that repressive
strategies will not solve the drug problem, andthat the war on drugs has not, and cannot, be won.
Governments do have the power to pursue a mix ofpolicies that are appropriate to their own situation,and manage the problems caused by drug markets
and drug use in a way that has a much more positive
impact on the level of related crime, as well as socialand health harms.
2. Replace the criminalization and punishment ofpeople who use drugs with the offer of health andtreatment services to those who need them.
A key idea behind the ‘war on drugs’ approach
was that the threat of arrest and harsh punishment
would deter people from using drugs. In practice,
this hypothesis has been disproved – many countries
that have enacted harsh laws and implemented
widespread arrest and imprisonment of drug users andlow-level dealers have higher levels of drug use andrelated problems than countries with more tolerant
approaches. Similarly, countries that have introduced
decriminalization, or other forms of reduction in arrestor punishment, have not seen the rises in drug use ordependence rates that had been feared.

DEC RIMINALIZAT ION INIT IAT IVE S
DO NOT RESULT IN SIGNIFIC A NT
INC REASES IN DRUG USE
Portugal
In July 2001, Portugal became the first European country
to decriminalize the use and possession of all illicit drugs.
Many observers were critical of the policy, believing that
it would lead to increases in drug use and associatedproblems. Dr. Caitlin Hughes of the University of New
South Wales and Professor Alex Stevens of the Universityof Kent have undertaken detailed research into the effects
of decriminalization in Portugal. Their recently publishedfindings26 have shown that this was not the case, replicating
the conclusions of their earlier study27 and that of the
CATO Institute28.
Hughes and Stevens’ 2010 report detects a slight increasein overall rates of drug use in Portugal in the 10 years sincedecriminalization, but at a level consistent with other similarcountries where drug use remained criminalized. Within thisgeneral trend, there has also been a specific decline in theuse of heroin, which was in 2001 the main concern of thePortuguese government. Their overall conclusion is thatthe removal of criminal penalties, combined with the useof alternative therapeutic responses to people struggling
with drug dependence, has reduced the burden of drug law
enforcement on the criminal justice system and the overalllevel of problematic drug use.
Comparing Dutch and US Cities
A study by Reinarman, et. al. compared the very
different regulatory environments of Amsterdam, whoseliberal “cannabis cafe” policies (a form of de facto
decriminalization) go back to the 1970s, and San Francisco,in the US, which criminalizes cannabis users. The researchers
wished to examine whether the more repressive policy
environment of San Francisco deterred citizens fromsmoking cannabis or delayed the onset of use. They foundthat it did not, concluding that:“Our findings do not support claims that criminalization
reduces cannabis use and that decriminalization increases
cannabis use... With the exception of higher drug use in
San Francisco, we found strong similarities across both cities.
We found no evidence to support claims that criminalization
reduces use or that decriminalization increases use.”29

10

Global Commission on Drug Policy

Australia
The state of Western Australia introduced adecriminalization scheme for cannabis in 2004, andresearchers evaluated its impact by comparing prevalence
trends in that state with trends in the rest of the country.
The study was complicated by the fact that it took place ina period when the use of cannabis was in general decline
across the country. However, the researchers found that
this downward trend was the same in Western Australia,
which had replaced criminal sanctions for the use orpossession of cannabis with administrative penalties,
typically the receipt of a police warning called a ‘noticeof infringement’. The authors state:“The cannabis use data in this study suggest that,
unlike the predictions of those public commentators
who were critical of the scheme, cannabis use inWestern Australia appears to have continued to decline
despite the introduction of the Cannabis Infringement
Notice Scheme.”30
Comparisons Between Different States in the US
Although cannabis possession is a criminal offense under
US federal laws, individual states have varying policies
toward possession of the drug. In the 2008 Report of
the Cannabis Commission convened by the Beckley
Foundation, the authors reviewed research that had been
undertaken to compare cannabis prevalence in thosestates that had decriminalized with those that maintained
criminal punishments for possession. They concluded that:“Taken together, these four studies indicated that states
which introduced reforms did not experience greater
increases in cannabis use among adults or adolescents.
Nor did surveys in these states show more favorable
attitudes towards cannabis use than those states which
maintained strict prohibition with criminal penalties.”31

In the light of these experiences, it is clear that thepolicy of harsh criminalization and punishment of drug
use has been an expensive mistake, and governments
should take steps to refocus their efforts and resourceson diverting drug users into health and social careservices. Of course, this does not necessarily mean thatsanctions should be removed altogether – many drug
users will also commit other crimes for which they need
to be held responsible – but the primary reaction to drug
possession and use should be the offer of appropriate
advice, treatment and health services to individuals whoneed them, rather than expensive and counterproductive
criminal punishments.
3. Encourage experimentation by governmentswith models of legal regulation of drugs (withcannabis, for example) that are designed toundermine the power of organized crime andsafeguard the health and security of their citizens.
The debate on alternative models of drug market
regulation has too often been constrained by false
dichotomies – tough or soft, repressive or liberal. In fact,
we are all seeking the same objective – a set of drug
policies and programs that minimize health and social
harms, and maximize individual and national security.
It is unhelpful to ignore those who argue for a taxed andregulated market for currently illicit drugs. This is apolicy option that should be explored with the same
rigor as any other.32
If national governments or local administrations feel thatdecriminalization policies will save money and deliver
better health and social outcomes for their communities,
or that the creation of a regulated market may reduce
the power of organized crime and improve the securityof their citizens, then the international community should
support and facilitate such policy experiments and learn
from their application.
Similarly, national authorities and the UN need to review
the scheduling of different substances. The current
schedules, designed to represent the relative risks andharms of various drugs, were set in place 50 years ago
when there was little scientific evidence on which tobase these decisions. This has resulted in some obvious
anomalies – cannabis and coca leaf, in particular, now
seem to be incorrectly scheduled and this needs tobe addressed.

Global Commission on Drug Policy

11

D I S C R E PANCIE S BE TWE E N
L E V E L S O F CONTR OL AND LEVELS O F HA RM

In a report published by The Lancet in 2007, a team ofscientists33 attempted to rank a range of psychoactive
drugs according to the actual and potential harms they
could cause to society. The graph at right summarizes
their findings and contrasts them with the seriousness
with which the drugs are treated within the global
drug control system.
While these are crude assessments, they clearlyshow that the categories of seriousness ascribed tovarious substances in international treaties need to bereviewed in the light of current scientific knowledge.

INDEPENDENT EXPERTA SSESSMENT S O F RISK
0.0

0.5

1.0

HeroinCocaineBarbiturates
Alcohol
Ketamine

U N C L AS S IFICATION

Benzodiazepines

Most Dangerous

Amphetamine

Moderate Risk

TobaccoLow Risk

Buprenorphine

Not Subject to International Control

Cannabis
Solvents
LSD
RitalinAnabolic Steroids
GHB
Ecstasy
Khat

10

Global Commission on Drug Policy

1.5

2.0

2.5

3.0

R E COMMEN D AT IO NS(Continued)

4. Establish better metrics, indicators and goals tomeasure progress.
The current system of measuring success in the drug
policy field is fundamentally flawed.34 The impact ofmost drug strategies are currently assessed by the levelof crops eradicated, arrests, seizures and punishments
applied to users, growers and dealers. In fact, arrestingand punishing drug users does little to reduce levelsof drug use, taking out low-level dealers simply createsa market opportunity for others, and even the largest
and most successful operations against organizedcriminals (that take years to plan and implement) havebeen shown to have, at best, a marginal and shortlived impact on drug prices and availability. Similarly,
eradication of opium, cannabis or coca crops merely
displaces illicit cultivation to other areas.
A new set of indicators is needed to truly show theoutcomes of drug policies, according to their harms or
benefits for individuals and communities – for example,
the number of victims of drug market-related violence
and intimidation; the level of corruption generated
by drug markets; the level of petty crime committed
by dependent users; levels of social and economic
development in communities where drug production,
selling or consumption are concentrated; the level ofdrug dependence in communities; the level of overdose
deaths; and the level of HIV or hepatitis C infection
among drug users. Policymakers can and should
articulate and measure the outcome of these objectives.
The expenditure of public resources should therefore
be focused on activities that can be shown to havea positive impact on these objectives. In the current
circumstances in most countries, this would mean
increased investment in health and social programs,
and improved targeting of law enforcement resources
to address the violence and corruption associated withdrug markets.35 In a time of fiscal austerity, we can nolonger afford to maintain multibillion dollar investmentsthat have largely symbolic value.

5. Challenge, rather than reinforce, common
misconceptions about drug markets, drug use
and drug dependence.
Currently, too many policymakers reinforce the ideathat all people who use drugs are ‘amoral addicts’, andall those involved in drug markets are ruthless criminal
masterminds. The reality is much more complex.
The United Nations makes a conservative estimatethat there are currently 250 million illicit drug users in
the world, and that there are millions more involvedin cultivation, production and distribution. We simply
cannot treat them all as criminals.
To some extent, policymakers’ reluctance toacknowledge this complexity is rooted in theirunderstanding of public opinion on these issues.
Many ordinary citizens do have genuine fears about thenegative impacts of illegal drug markets, or the behaviorof people dependent on, or under the influence of,illicit drugs. These fears are grounded in some generalassumptions about people who use drugs and drug
markets, that government and civil society experts needto address by increasing awareness of some established(but largely unrecognized) facts. For example:• The majority of people who use drugs do not fit thestereotype of the ‘amoral and pitiful addict’. Of theestimated 250 million drug users worldwide, the United
Nations estimates that less than 10 percent can beclassified as dependent, or ‘problem drug users’.36• Most people involved in the illicit cultivation of coca,
opium poppy, or cannabis are small farmers struggling
to make a living for their families. Alternative livelihood
opportunities are better investments than destroying
their only available means of survival.
• The factors that influence an individual’s decision tostart using drugs have more to do with fashion, peer
influence, and social and economic context, than withthe drug’s legal status, risk of detection, or government
prevention messages.37, 38• The factors that contribute to the development ofproblematic or dependent patterns of use have more
to do with childhood trauma or neglect, harsh living
conditions, social marginalization, and emotional
problems, rather than moral weakness or hedonism.39

Global Commission on Drug Policy

13

R E COMMEN D AT IO NS(Continued)• It is not possible to frighten or punish someone out of drug
dependence, but with the right sort of evidence-based
treatment, dependent users can change their behavior andbe active and productive members of the community.40• Most people involved in drug trafficking are petty dealers
and not the stereotyped gangsters from the movies – thevast majority of people imprisoned for drug dealing or
trafficking are ‘small fish’ in the operation (often coerced
into carrying or selling drugs), who can easily be replaced
without disruption to the supply.41,42
A more mature and balanced political and media discourse
can help to increase public awareness and understanding.
Specifically, providing a voice to representatives of farmers,
users, families and other communities affected by drug
use and dependence can help to counter myths andmisunderstandings.
6. Countries that continue to invest mostly in a law
enforcement approach (despite the evidence) should
focus their repressive actions on violent organizedcrime and drug traffickers, in order to reduce theharms associated with the illicit drug market.
The resources of law enforcement agencies can be much
more effectively targeted at battling the organized crimegroups that have expanded their power and reach on theback of drug market profits. In many parts of the world,
the violence, intimidation and corruption perpetrated
by these groups is a significant threat to individual andnational security and to democratic institutions, so efforts
by governments and law enforcement agencies to curtailtheir activities remain essential.
However, there is a need to review our tactics in this fight.
There is a plausible theory put forward by MacCoun andReuter43 that suggests that supply reduction efforts aremost effective in a new and undeveloped market, where
the sources of supply are controlled by a small numberof trafficking organizations. Where these conditions exist,
appropriately designed and targeted law enforcement
operations have the potential to stifle the emergence of
new markets. We face such a situation now in West Africa.
On the other hand, where drug markets are diverse andwell-established, preventing drug use by stopping supply
is not a realistic objective.

14

Global Commission on Drug Policy

DRUGS IN W EST A FRIC A :RESP ONDING T O T HE GRO W IN G
C HA LLENGE O F NA RC O T RAFFI C
AND O RGANIZED C RIME
In just a few years, West Africa has become a major transit
and re-packaging hub for cocaine following a strategic shiftof Latin American drug syndicates toward the European
market. Profiting from weak governance, endemic poverty,
instability and ill-equipped police and judicial institutions,and bolstered by the enormous value of the drug trade,
criminal networks have infiltrated governments, state
institutions and the military. Corruption and money
laundering, driven by the drug trade, pervert local politics
and skew local economies.
A dangerous scenario is emerging as narco-traffic threatens
to metastasize into broader political and security challenges.
Initial international responses to support regional andnational action have not been able to reverse this trend.
New evidence44 suggests that criminal networks are
expanding operations and strengthening their positions
through new alliances, notably with armed groups. Current
responses need to be urgently scaled up and coordinatedunder West African leadership, with international financial
and technical support. Responses should integrate
law enforcement and judicial approaches with social,
development and conflict prevention policies – and theyshould involve governments and civil society alike.

We also need to recognize that it is the illicit nature of themarket that creates much of the market-related violence– legal and regulated commodity markets, while notwithout problems, do not provide the same opportunities
for organized crime to make vast profits, challenge thelegitimacy of sovereign governments, and, in some cases,
fund insurgency and terrorism.
This does not necessarily mean that creating a legal
market is the only way to undermine the power andreach of drug trafficking organizations. Law enforcement
strategies can explicitly attempt to manage and shape
the illicit market by, for example, creating the conditions
where small-scale and private ‘friendship network’ typesof supply can thrive, but cracking down on larger-scale
operations that involve violence or inconvenience to thegeneral public. Similarly, the demand for drugs from thosedependent on some substances (for example, heroin)can be met through medical prescription programs that
automatically reduce demand for the street alternative.
Such strategies can be much more effective in reducing
market-related violence and harms than futile attempts
to eradicate the market entirely.
On the other hand, poorly designed drug law enforcement
practices can actually increase the level of violence,
intimidation and corruption associated with drug
markets. Law enforcement agencies and drug trafficking
organizations can become embroiled in a kind of ‘arms
race’, in which greater enforcement efforts lead to a similar
increase in the strength and violence of the traffickers.
In this scenario, the conditions are created in which themost ruthless and violent trafficking organizations thrive.
Unfortunately, this seems to be what we are currently
witnessing in Mexico and many other parts of the world.

LAW ENFORC EMENT A ND
T HE ESC A LAT ION OF VIOLENCE
A group of academics and public health experts basedin British Columbia have conducted a systematic review
of evidence45 relating to the impact of increased law
enforcement on drug market-related violence (for example,
armed gangs fighting for control of the drug trade, or
homicide and robberies connected to the drug trade).
In multiple US locations, as well as in Sydney, Australia,
the researchers found that increased arrests and law
enforcement pressures on drug markets were strongly
associated with increased homicide rates and otherviolent crimes. Of all the studies examining the effect ofincreased law enforcement on drug market violence,
91 percent concluded that increased law enforcement
actually increased drug market violence. The researchersconcluded that:“The available scientific evidence suggests that
increasing the intensity of law enforcement interventions
to disrupt drug markets is unlikely to reduce drug gang
violence. Instead, the existing evidence suggests that
drug-related violence and high homicide rates are likely
a natural consequence of drug prohibition and that
increasingly sophisticated and well-resourced methods of
disrupting drug distribution networks may unintentionally
increase violence.”46
In the UK also, researchers have examined the effects ofpolicing on drug markets, noting that:“Law enforcement efforts can have a significant negative
impact on the nature and extent of harms associated withdrugs by (unintentionally) increasing threats to publichealth and public safety, and by altering both the behavior
of individual drug users and the stability and operation of
drug markets (e.g. by displacing dealers and related activity
elsewhere or increasing the incidence of violence
as displaced dealers clash with established ones).”47

Global Commission on Drug Policy

15

R E COMMEN D AT IO NS(Continued)

7. Promote alternative sentences for small-scale andfirst-time drug dealers.

rates of drug use through mass prevention campaigns
were poorly planned and implemented. While thepresentation of good (and credible) information on
the risks of drug use is worthwhile, the experience ofuniversal prevention (such as media campaigns, or
school-based drug prevention programs) has been
mixed. Simplistic ‘just say no’ messages do not seemto have a significant impact.49

While the idea of decriminalization has mainly been
discussed in terms of its application to people who use
drugs or who are struggling with drug dependence,
we propose that the same approach be considered
for those at the bottom of the drug selling chain.
The majority of people arrested for small-scale drug
selling are not gangsters or organized criminals.
They are young people who are exploited to do therisky work of street selling, dependent drug users trying
to raise money for their own supply, or couriers coerced
or intimidated into taking drugs across borders. These
people are generally prosecuted under the same legal
provisions as the violent and organized criminals who
control the market, resulting in the indiscriminate
application of severe penalties.

There have been some carefully planned and targeted
prevention programs, however, that focus on social skills
and peer influences that have had a positive impact on
the age of initiation or the harms associated with druguse. The energy, creativity and expertise of civil society
and community groups are of particular importancein the design and delivery of these programs. Youngpeople are less likely to trust prevention messages
coming from state agencies.

Around the world, the vast majority of arrests are ofthese nonviolent and low-ranking ‘little fish’ in the drug
market. They are most visible and easy to catch, and do
not have the means to pay their way out of trouble.48
The result is that governments are filling prisons withminor offenders serving long sentences, at great cost,
and with no impact on the scale or profitability ofthe market.
In some countries, these offenders are even subject tothe death penalty, in clear contravention of international
human rights law. To show their commitment tofighting the drug war, many countries implement laws
and punishments that are out of proportion to theseriousness of the crime, and that still do not have asignificant deterrent effect. The challenge now is forgovernments to look at diversion options for the ‘little
fish’, or to amend their laws to make a clearer and more
proportionate distinction between the different types ofactors in the drug market.

Successful models of prevention have tended to target
particular groups at risk – gang members, children incare, or in trouble at school or with the police – with
mixed programs of education and social support thatprevent a proportion of them from developing into
regular or dependent drug users. Implemented to a
sufficient scale, these programs have the potential
to reduce the overall numbers of young people who
become drug dependent or who get involved inpetty dealing.
9. Offer a wide and easily accessible range of options
for treatment and care for drug dependence,
including substitution and heroin-assisted treatment,with special attention to those most at risk, including
those in prisons and other custodial settings.

8. Invest more resources in evidence-based prevention,with a special focus on youth.
Clearly, the most valuable investment would be in
activities that stop young people from using drugs in
the first place, and that prevent experimental users
from becoming problematic or dependent users.
Prevention of initiation or escalation is clearly preferable
to responding to the problems after they occur.
Unfortunately, most early attempts at reducing overall

16

Global Commission on Drug Policy

In all societies and cultures, a proportion of individuals
will develop problematic or dependent patterns ofdrug use, regardless of the preferred substances in thatsociety or their legal status. Drug dependence can bea tragic loss of potential for the individual involved,
but is also extremely damaging for their family, theircommunity, and, in aggregate, for the entire society.
Preventing and treating drug dependence is therefore
a key responsibility of governments – and a valuable
investment, since effective treatment can deliversignificant savings in terms of reductions in crime andimprovements in health and social functioning.

Many successful treatment models – using a mix ofsubstitution treatment and psycho-social methods– have been implemented and proven in a range ofsocio-economic and cultural settings. However, inmost countries, the availability of these treatments islimited to single models, is only sufficient to meet asmall fraction of demand, or is poorly targeted and fails
to focus resources on the most severely dependent
individuals. National governments should therefore
develop comprehensive, strategic plans to scale
up a menu of evidence-based drug dependence
treatment services.
At the same time, abusive practices carried out in thename of treatment – such as forced detention, forcedlabor, physical or psychological abuse – that contravene
human rights standards by subjecting people to cruel,inhuman and degrading treatment, or by removing
the right to self-determination, should be abolished.
Governments should ensure that their drug dependence
treatment facilities are evidence-based and comply withinternational human rights standards.
10.The United Nations system must provide leadershipin the reform of global drug policy. This means
promoting an effective approach based on evidence,
supporting countries to develop drug policies
that suit their context and meet their needs, andensuring coherence among various UN agencies,
policies and conventions.
While national governments have considerable
discretion to move away from repressive policies,
the UN drug control system continues to act largely
as a straitjacket, limiting the proper review andmodernization of policy. For most of the last century,
it has been the US government that has led calls forthe development and maintenance of repressive drug
policies. We therefore welcome the change of tone
emerging from the current administration50 – with
President Obama himself acknowledging the futilityof a ‘war on drugs’ and the validity of a debate on
alternatives.51 It will be necessary, though, for the US tofollow up this new rhetoric with real reform, by reducing
its reliance on incarceration and punishment of drug
users, and by using its considerable diplomatic influence
to foster reform in other countries.

UN drug control institutions have largely acted as
defenders of traditional policies and strategies. In theface of growing evidence of the failure of these strategies,
reforms are necessary. There has been some encouraging
recognition by UNODC that there is a need to balance
and modernize the system, but there is also strong
institutional resistance to these ideas.
Countries look to the UN for support and guidance.
The UN can, and must, provide the necessary leadershipto help national governments find a way out of the current
policy impasse. We call on UN Secretary General Ban
Ki-moon and UNODC Executive Director Yury Fedotov
to take concrete steps toward a truly coordinated andcoherent global drug strategy that balances the needto stifle drug supply and fight organized crime with theneed to provide health services, social care, and economic
development to affected individuals and communities.
There are a number of ways to make progress on thisobjective. For a start, the UN could initiate a wideranging commission to develop a new approach; UN
agencies could create new and stronger structures forpolicy coordination; and the UNODC could foster moremeaningful program coordination with other UN agencies
such as the WHO, UNAIDS, UNDP, or the Office of the
UN High Commissioner for Human Rights.
11. Act urgently: the war on drugs has failed, andpolicies need to change now.
There are signs of inertia in the drug policy debate insome parts of the world, as policymakers understandthat current policies and strategies are failing but do notknow what to do instead. There is a temptation to avoid
the issue. This is an abdication of policy responsibility –for every year we continue with the current approach,billions of dollars are wasted on ineffective programs,
millions of citizens are sent to prison unnecessarily,
millions more suffer from the drug dependence of
loved ones who cannot access health and social careservices, and hundreds of thousands of people die frompreventable overdoses and diseases contracted throughunsafe drug use.
There are other approaches that have been proven to
tackle these problems that countries can pursue now.
Getting drug policy right is not a matter for theoretical or
intellectual debate – it is one of the key policy challengesof our time.

Global Commission on Drug Policy

17

E ND NO T ES

1

For detailed analysis of illicit drug markets over the decade, see: Reuter,
P. and Trautmann, F. (2009) A Report on Global Illicit Drug Markets
1998-2007. European Commission http://www.exundhopp.at/www1/drogenbericht.pdf Accessed 04.19.11

14

Killias, M. and Aebi, M.F. (2000) “The impact of heroin prescription on
heroin markets in Switzerland,” Crime Prevention Studies, volume 11,2000 http://www.popcenter.org/library/crimeprevention/volume_11/
04-Killias.pdf Accessed 05.08.11

2

UNODC (2008) 2008 World Drug Report Vienna: United Nations
http://www.unodc.org/unodc/en/data-and-analysis/WDR-2008.html
Accessed 04.19.11

15

Millar, T., Jones, A., Donmall, M. and Roxburgh, M. (2008) Changes inoffending following prescribing treatment for drug misuse National
Treatment Agency for Substance Misuse http://www.nta.nhs.uk/uploads/
nta_changes_in_offending_rb35.pdf Accessed 05.08.11

3

European Monitoring Centre on Drugs and Drug Addiction (2010) Annual
Report of the State of the Drugs Problem in Europe http://www.emcdda.
europa.eu/publications/annual-report/2010 Accessed 04.19.11

16

National Drug Monitor (2009) NDM Annual Report, 2009 WODC/Trimbos
Instituut http://english.wodc.nl/images/1730_full_text_tcm45-296585.pdf
Accessed 05.08.11

National Drug Intelligence Centre (2010) National Drug Threat
Assessment Washington: US Department of Justice http://www.justice.
gov/ndic/pubs38/38661/index.htm Accessed 04.18.11

17

van Laar, M. and van Ooyen-Houben, M. (eds.) (2009) Evaluatie van het
Nederlandse drugsbeleid WODC/Trimbos Instituut http://www.trimbos.
nl/~/media/Files/Gratis percent20downloads/AF0884 percent20Evaluatie
percent20van percent20het percent20Nederlands percent20drugsbeleid.
ashx Accessed 05.08.11

18

E. Schatz, K. Schiffer and J.P. Kools (2011) The Dutch treatment and social
support system for drug users IDPC Briefing Paper, January 2011
http://www.idpc.net/publications/idpc-paper-dutch-drug-treatmentprogram Accessed 05.08.11

19

Henman, A. and Metaal, P. (2009) Coca Myths Transnational Institute Drugs
and Democracy Program http://www.tni.org/archives/reports_drugs_
debate13 Accessed 04.21.11

4

5

6

Office of the United Nations High Commissioner for Human Rights (2009)
High Commissioner calls for focus on human rights and harm reduction ininternational drug policy Geneva: United Nations http://www.ohchr.org/
documents/Press/HC_human_rights_and_harm_reduction_drug_policy.
pdf Accessed 04.18.11
World Health Organization, UN Office on Drugs and Crime, and Joint UN
Program on HIV and AIDS (2009) WHO, UNODC, UNAIDS technical guidefor countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users http://www.unodc.org/documents/
hiv-aids/idu_target_setting_guide.pdf Accessed 04.18.11

7

European Monitoring Centre for Drugs and Drug Addiction (2010)
Harm reduction: evidence, impacts and challenges. Lisbon: EMCDDA
http://www.emcdda.europa.eu/publications/monographs/harm-reduction
Accessed 05.13.11

20

Jelsma, M. (2011) Lifting the Ban on Coca Chewing: Bolivia’s proposal toamend the 1961 Single Convention Series on Legislative Reform of Drug
Policies, No.11. Transnational Institute http://www.tni.org/briefing/liftingban-coca-chewing Accessed 05.08.11

8

See the European Monitoring Centre on Drugs and Drug Addiction
resources page on harm reduction: http://www.emcdda.europa.eu/
themes/harm-reduction Accessed 04.19.11

21

Costa, A.M. (2008) Making drug control ‘fit for purpose’: Building on the
UNGASS Decade E/CN.7/2008/CRP.17 http://www.unodc.org/documents/
commissions/CND-Session51/CND-UNGASS-CRPs/ECN72008CRP17E.pdf
Accessed 04.20.11

9

Mathers, B., Degenhardt, L., Phillips, B., Wiessing, L., Hickman, M.,
Strathdee, S., Wodak, A., Panda, S., Tyndall, M., Toufik, A., and Mattick, R.
for the 2007 Reference Group to the UN on HIV and Injecting drug use(2008) “Global epidemiology of injecting drug use and HIV among people
who inject drugs: a systematic review” The Lancet, Volume 372, Issue
9651, pp.1733–1745. Data available at: http://www.idurefgroup.unsw.edu.
au//IDURGWeb.nsf/page/IDUepi Accessed 04.16.11

22

Godfrey C., Stewart D., and Gossop, M. (2004) “Economic analysis ofcosts and consequences of the treatment of drug misuse: 2-year outcome
data from the National Treatment Outcome Research Study (NTORS)”
Addiction 99 (6) pp.697-707

23

Reuter, P. and Pollack, H. (2006) “How much can treatment reduce national
drug problems?” Addiction 101 (3) pp. 341-347

24

Carnevale, J. (2009) Restoring the Integrity of the Office of National
Drug Control Policy Written Testimony to the Domestic Policy
Subcommitee of the Committee on Oversight and Government Reform
http://www.idpc.net/publications/john-carnevale-testimony-ONDCPcongress Accessed 04.21.11

25

Bühringer, G., Farrell, M., Kraus, L., Marsden, J., Pfeiffer-Gerschel, T.,
Piontek, D., Karachaliou, K., Künzel, J. and Stillwell, G. (2009) Comparative
analysis of research into illicit drugs in the European Union Luxembourg:
European Commission, Directorate-General Justice, Freedom andSecurity http://www.emcdda.europa.eu/attachements.cfm/att_118348_
EN_report-EN.pdf Accessed 05.13.11

10

UNAIDS (2010) UNAIDS Report on the Global AIDS Epidemic 2010
http://www.unaids.org/globalreport/Global_report.htm Accessed 04.18.11

11

WHO (2006) Treatment of Injecting Drug Users with HIV/AIDS:
Promoting Access and Optimizing Service Delivery Geneva: World
Health Organization http://www.who.int/substance_abuse/publications/
treatment/en/index.html Accessed 04.16.11

12

US Institute of Medicine (2006) Preventing HIV Infection among
Injecting Drug Users in High Risk Countries: An Assessment of the
Evidence Washington: National Academies Press http://www.nap.edu/
catalog.php?record_id=11731 Accessed 04.16.11

13

Aebi, M. F., Ribeaud D., and Killias, M. (1999) ”Prescription médicale destupéfiants et délinquance. Résultats des essais Suisses.” Criminologie,
vol. 32, n.2

18

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26

Hughes, C.E. and Stevens, A. (2010) “What Can We Learn from thePortuguese Decriminalization of Illicit Drugs?” British Journal of
Criminology Volume 50, Issue 6, pp.999-1022

27

Hughes, C.E. and Stevens, A. (2007) The Effects of Decriminalizationof Drug Use in Portugal Oxford: Beckley Foundation http://www.
beckleyfoundation.org/bib/doc/bf/2007_Caitlin_211672_1.pdf
Accessed 04.20.11

28

Greenwald, G. (2009) Drug Decriminalization in Portugal: Lessons for
Creating Fair and Successful Drug Policies Cato Institute http://www.cato.
org/pub_display.php?pub_id=10080 Accessed 05.07.11

29

Reinarman, C., Cohen, P. and Kaal, H. (2004) “The Limited Relevance ofDrug Policy: Cannabis in Amsterdam and in San Francisco” American
Journal of Public Health vol. 94 pp.836–842

30

Fetherston, J. and Lenton, S. (2007) Effects of the Western AustralianCannabis Infringement Notification Scheme on Public Attitudes,
Knowledge and Use: Comparison of Pre- and Post Change Data Perth:National Drug Research Institute http://ndri.curtin.edu.au/local/docs/pdf/
publications/T177.pdf Accessed 04.20.11

31

32

Room, R., Fischer, B., Hall, W., Lenton, S. and Reuter, P. (2008) The Global
Cannabis Commission Report Oxford: Beckley Foundation http://www.
beckleyfoundation.org/pdf/BF_Cannabis_Commission_Report.pdf
Accessed 04.20.11
Becker, G.S., Murphy, K.M. and Grossman, M. (2004) The Economic
Theory of Illegal Goods: The Case of Drugs National Bureau of Economic
Research, Working Paper 10976 http://www.nber.org/papers/w10976
Accessed 05.13.11

33

Nutt, D., King, L.A., Saulsbury, W. and Blakemore, C. (2007) “Developmentof a rational scale to assess the harm of drugs of potential misuse” Lancet
Vol. 369 (9566) pp.1047-53

34

Hallam, C. and Bewley-Taylor, D. (2010) “Mapping the World Drug
Problem: Science and Politics in the United Nations Drug Control
System,” International Journal of Drug Policy, Volume 21, (1), 2010, pp. 1-3

35

Caulkins, J., Reuter, P. Iguchi, M.Y. and Chiesa, J. (2005) How Goes the“War on drugs”? An Assessment of US Problems and Policy Santa Monica,
California: RAND http://www.rand.org/pubs/occasional_papers/2005/
RAND_OP121.pdf Accessed 04.20.11

36

UNODC (2008) 2008 World Drug Report Vienna: United Nations
http://www.unodc.org/unodc/en/data-and-analysis/WDR-2008.html
Accessed 04.19.11

37

Lalander, P. and Salasuo, M. (Eds.) (2005) “Drugs and Youth Cultures:
Global and Local Expressions” Helsinki: Nordic Council for Alcohol andDrug Research

38

Manning, P. (Ed.) (2007) Drugs and Popular Culture: Drugs, Media and
Identity in Contemporary Society Devon: Willan Publishing

39

Buchanan, J. (2004) “Missing Links? Problem drug use and social
exclusion” Probation Journal vol. 51 no. 4 pp. 387-397

40

UNODC/WHO (2008) Principles of Drug Dependence Treatment
http://www.unodc.org/documents/drug-treatment/UNODC-WHOPrinciples-of-Drug-Dependence-Treatment-March08.pdf
Accessed 04.16.11

41

Bewley-Taylor, D., Hallam, C. and Allen, R. The Incarceration of Drug
Offenders: An Overview Beckley Foundation/International Centre for
Prison Studies http://www.idpc.net/php-bin/documents/Beckley_
Report_16_2_FINAL_EN.pdf Accessed 04.19.11

42

Sevigny, E. and Caulkins, J.P. (2004) “Kingpins or Mules? An Analysis ofDrug Offenders Incarcerated in Federal and State Prisons” Criminology
and Public Policy 3:3, 401-434

43

MacCoun, R.J. and and Reuter, P. (2001) Drug War Heresies: Learning from
Other Vices, Times and Places Cambridge University Press

44

UNODC (2008) Drug trafficking as a security threat to West Africa Vienna:
United Nations http://www.unodc.org/documents/data-and-analysis/
Studies/Drug-Trafficking-WestAfrica-English.pdf Accessed 05.08.11

45

Werb, D., Rowell, G., Guyatt, G., Kerr, T., Montaner, J. and Wood, E. (2011)“Effect of drug law enforcement on drug market violence: A systematic
review” International Journal of Drug Policy vol. 22 pp. 87–94

46

Werb, D., Rowell, G., Guyatt, G., Kerr, T. Montaner, J. and Wood, E. (2010)
Effect of Drug Law Enforcement on Drug-related Violence: Evidence froma Scientific Review Urban Health Research Initiative, British Colombia
Centre for Excellence in HIV/AIDS http://www.icsdp.org/Libraries/doc1/
ICSDP-1_-_FINAL_1.sflb.ashx Accessed 04.19.11

47

McSweeney, T., Turnbull, P.J. and Hough, M (2008) Tackling Drug Markets& Distribution Networks in the UK London: UK Drug Policy Commission
http://www.ukdpc.org.uk/resources/Drug_Markets_Full_Report.pdf
Accessed 04.19.11

48

Metaal, P. and Youngers, C. eds. (2011) Systems Overload: Drug Laws andPrisons in Latin America Transnational Institute/Washington Office on
Latin America http://www.druglawreform.info/images/stories/documents/
Systems_Overload/TNI-Systems_Overload-def.pdf Accessed 05.16.11

49

Perry, C. L., Komro, K. A., Veblen-Mortenson, S., Bosma, L. M., Farbakhsh,K., Munson, K. A., et al. (2003) “A randomized controlled trial of the
middle and junior high school D.A.R.E. and D.A.R.E. Plus programs”
Archives of Pediatrics & Adolescent Medicine 157(2), pp. 178-184

50

Office of National Drug Control Policy (2010) National Drug Control
Strategy 2010 http://www.whitehousedrugpolicy.gov/strategy/index.html
Accessed 05.13.11

51“Obama: Drugs Should be Treated as a Public Health Problem”
Interview with Barack Obama on CBS News: http://www.cbsnews.
com/8301-503544_162-20029831-503544.html Accessed 05.13.11

Global Commission on Drug Policy

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S E C R E TA R I AT

BAC KGROUND PAP ERS(available at www.globalcommissionondrugs.org)

Bernardo Sorj
Ilona Szabó de Carvalho
Miguel Darcy de Oliveira

Demand reduction and harm reduction
Dr. Alex Wodak

A D V IS O R S

Drug policy, criminal justice and mass imprisonment
Bryan Stevenson

Dr. Alex Wodak, Australian Drug Law
Reform Foundationwww.adlrf.org.au

Assessing supply-side policy and practice: eradication
and alternative development
David Mansfield

Ethan Nadelmann, Drug Policy Alliancewww.drugpolicy.org

The development of international drug control: lessons
learned and strategic challenges for the future
Martin Jelsma

Martin Jelsma, Transnational Institutewww.tni.org/drugs
Mike Trace, International Drug Policy Consortium
www.idpc.net

S U PPO R T
Centro Edelstein de Pesquisas Sociais
Instituto Fernando Henrique Cardoso
Open Society Foundations
Sir Richard Branson, founder and chairman of
Virgin Group (Support provided throughVirgin Unite)

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Global Commission on Drug Policy

Drug policy: lessons learned and options for the future
Mike Trace
The drug trade: the politicization of criminals andthe criminalization of politiciansMoisés Naím

FO R ADDIT IONA L RESO URC ES, SE E :www.unodc.org
www.idpc.net
www.drugpolicy.org
www.talkingdrugs.org
www.tni.org/drugs
www.ihra.net
www.countthecosts.org
www.intercambios.org.ar
www.cupihd.org
www.wola.org/program/drug_policy
www.beckleyfoundation.org
www.comunidadesegura.org

G L O B A L COMMIS S ION ON
D R U G PO LICY
The purpose of the Global Commission on Drug Policy
is to bring to the international level an informed,
science-based discussion about humane and effective
ways to reduce the harm caused by drugs to people
and societies.

GOALS• Review the basic assumptions, effectiveness andconsequences of the ‘war on drugs’ approach• Evaluate the risks and benefits of different national
responses to the drug problem• Develop actionable, evidence-based recommendations
for constructive legal and policy reform

www.globalcommissionondrugs.org
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Global Commission on Drug Policy