International Drug Reform: Medicalised Harm Reduction, Cannabis and the Global Legislative Reality

Abstract Despite being the global legislative reality for more than half a century, when it comes to the control and management of illicit drugs, there is still a sharp academic divide between strict prohibitionists and open access legalisers, with both sides claiming supremacy in their ability to reduce the harms drug users face. Spanning these opposing academic extremes, governments around the world have experimented with, or put into practice a range of alternatives to prohibition that generally hold harm reduction as a centrally guiding principle. However, in the realm of drugs control, harm reduction is not a simple utilitarian problem and is often clouded by a number of moral aspects that will seemingly continue to frustrate the prospects for consensus among the various drug control stakeholders for the near future. Moreover, while proponents of reform and legalisation have put forth seemingly plausible and well considered theories for the regulation and control of drugs in lieu of prohibition, it has become rather clear in the wake of the recent United Nations Special Assembly on Drugs in 2016 that a significant top-down change in international drugs control policy is unlikely for the foreseeable future. This is not to say the global prohibitionist framework is destined to remain predominant, and clear lines are emerging for the practical evolution of international drugs control policy. With an ever expanding variety of novel alternative methods being implemented by countries around the world to reduce the harm from illicit drug use, especially with regards to the unique challenges faced by intractable, chronic users of ’hard’ drugs such as heroin, coupled with a softening of hard-line attitudes, a path towards sensible drug reforms is becoming clearer. This short article examines a number of those alternative methods, where it is argued that medicalised harm reduction for ’hard’ drugs is the most likely to find broad acceptance under the international drug regime and the growing tolerance and liberalisation of cannabis laws will likely continue because of its relatively low risk profile and high cost of prohibition.