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<p> A commission convened by Johns Hopkins and <em>The Lancet</em> call on a UN General Assembly Special Session to take a public health approach to drug policy.</p>

Top Medical Experts: Decriminalize Drugs for Public Health

By Jill Drachenberg, Managing Editor

Decriminalize nonviolent drug use and possession globally and take a public health approach to combat drug abuse, declared a report from the Johns Hopkins-Lancet Commission on Public Health and International Drug Policy. The commission includes 22 top medical experts from low-, middle-, and high-income countries convened by Johns Hopkins University and medical journal The Lancet.

Drug laws intended to protect have contributed to lethal violence, disease transmission, discrimination, forced displacement and undermined people's right to health and “have contributed directly and indirectly to lethal violence, communicable-disease transmission, discrimination, forced displacement, unnecessary physical pain, and the undermining of people’s right to health,” according to the report. Such policies have also lead to higher rates of HIV, hepatitis C, and tuberculosis infection in intravenous drug users; a reduced life expectancy in Mexico due to an increase in homicides since the government began using military force against drug traffickers; racial and gender biases in drug policy and enforcement in the United States; and higher risk of drug overdose deaths.

“The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, and alcohol, for which the goal of social policy is to reduce potential harms,” the commission wrote.

The commission proposed a number of recommendations in its report, including the following:

  • Decriminalize minor, nonviolent drug offenses – such as use and possession – and broaden access to health and treatment alternatives.
  • Phase out the use of military forces in drug policing, eliminate racial and ethnic discrimination in policing, and focus more resources on the most violent criminals to reduce harm and violence.
  • Easy access to harm-reduction services for all who need them, including opioid substitution therapy, needle and syringe programs, supervised injection sites, and access to the opioid overdose-reversing drug naloxone, in health services.
  • Humane and scientifically sound drug dependence treatments should be available in prisons globally.
  • Improved U.N. governance of drug policy.
  • A gradual move toward regulated drug markets, with the scientific method applied to assessment.

The report was released ahead of the U.N. General Assembly Special Session (UNGASS), which will take place April 19. It will be the first UNGASS on drug policy since 1998.

"The goal of prohibiting all use, possession, production, and trafficking of illicit drugs is the basis of many of our national drug laws, but these policies are based on ideas about drug use and drug dependence that are not scientifically grounded," says commission member Chris Beyrer, MD, of Johns Hopkins Bloomberg School of Public Health in Baltimore. "The global 'war on drugs' has harmed public health, human rights and development. It's time for us to rethink our approach to global drug policies, and put scientific evidence and public health at the heart of drug policy discussions."

AHC Media continues closely monitoring all the action on the opioid epidemic. In the February issue of ED Management, author Dorothy Brooks examined what were then the CDC’s draft recommendations on opioid abuse, which weren't without controversy, as well as alternative recommendations made by others. The March issue of Medical Ethics Advisor weighs the ethical boundaries of opioid “pain agreements” while the March issue of Primary Care Reports reviews safe strategies for prescribing opioids. AHC also offers an on-demand webinar detailing safe opioid prescription guidelines.