Embracing a harm reduction and public health perspective, one of the world's most prestigious medical journals has released a signed editorial calling for the legalization, taxation, and regulation of currently illegal drugs.

[image:1 align:left]In a editorial last Thursday entitled Drugs Should Be Legalised, Regulated, and Taxed, Fiona Godlee, editor in chief of the British Medical Journal, notes that under drug prohibition, the global trade "fuels organized crime and human misery," and asks, "Why should it not instead fund public services?"

Citing an opinion piece in the same issue of the BMJ from British members of the Law Enforcement Action Partnership (LEAP, formerly known as Law Enforcement Against Prohibition) Jason Reed and Paul Whitehouse, Godlee notes that in the United Kingdom (as in the United States) "vast sums are spent prosecuting individuals and trying vainly to interrupt the flow of drugs into cities" while that money would be much better "spent on quality control, education, treatment for drug users, and child protection." Under legalization, "revenues could be diverted from criminal gangs into government coffers," she writes.

Godlee notes that the global drug prohibition consensus is fraying around the edges, and points to the example of Portugal, which decriminalized the possession of all drugs in 2001. There, drug use remains in line with levels in other European countries, but the harms associated with drug use under prohibition have decreased dramatically, particularly in terms of fatal drug overdoses and the spread of injection drug-related infectious disease.

Godlee also pointed to the Netherlands, the United States, and soon, Canada, where "regulated markets for the sale of cannabis generate substantial tax revenues."

Again returning to the opinion piece by Reed and Whitehouse, Godlee writes that "when law enforcement officers call for drugs to be legalized, we have to listen." Ditto for when doctors speak up, she adds, noting that just last month, the Royal College of Physicians came out in favor of drug decriminalization, joining the British Medical Association, the Faculty of Public Health, and the Royal Society of Public Health in supporting drug policy reform.

"This is not about whether you think drugs are good or bad," Godlee concludes. "It is an evidence based position entirely in line with the public health approach to violent crime… The BMJ is firmly behind efforts to legalize, 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."

Unfortunately for the BMJ and the other public health advocates, as in the United States, the political class in the United Kingdom isn't yet on board with evidence-based best practices on drug policy. But this editorial loosens another brick in the wall -- on both sides of the Atlantic.