Criminalizing the use of marijuana and other tough on crime approaches haven't worked, say public health doctors from across Canada who propose taxation and regulation instead.
The chief medical health officers in three provinces wrote a paper reviewing the evidence on Canada's current illicit drug policies in Wednesday's issue of the journal Open Medicine.
The paper comes as the federal government is set to table its budget amid funding questions for Bill C-10, which includes mandatory minimum sentences for minor drug offences.
Looking at illegal drugs solely based on a criminal justice approach has failed, said Dr. Robert Strang, Nova Scotia's chief medical health officer, a co-author of the paper.
"For the last decade, Portugal has decriminalized all drug use and they have some of the lowest rates of drug use in Europe and they have some of the least amounts of harm from drug use," Strang said.
In contrast, drug use hasn't decreased since the $1-trillion US "war on drugs" was declared and aggressive drug law enforcement began.
In the U.S., New York, Michigan and Massachusetts and Connecticut are now repealing minimum legislation for non-violent drug offences, said Dr. Evan Wood, co-director of the Urban Health Research Initiative at the B.C. Centre for Excellence in HIV/AIDS, another co-author of the paper.
With tough drug enforcement policies, organized crime has profited, incarcerated drug users have suffered HIV and hepatitis outbreaks and gun violence problems have grown, the doctors said.
Strang, Dr. Perry Kendall, chief provincial medical health officer for B.C. and Dr. Moira McKinnon, who holds the same job in Saskatchewan, wrote that opponents to drug policy reform commonly argue drug use would increase if health-based models were stressed over drug law enforcement.
But they said a recent study by the World Health Organization concluded that countries with stringent illegal drug policies for users did not have lower levels of use than those with liberal policies.
The authors said governments need to consider other approaches that include public health objectives that minimize health and social harms, such as:
Taxing marijuana as alcohol and tobacco are.
Licensing cannabis dispensaries and issuing prescriptions for medical marijuana.
Implementing age limits and other sales restrictions like those used to reduce alcohol use.
Regulating and controlling the availability of potent substances to reduce the illegal market.
The chief medical officers of health in Canada's 18 largest cities have also endorsed the Vienna Declaration, a global statement calling for illicit drug use policies to incorporate scientific evidence, such as studies on the effectiveness of needle exchange programs and methadone maintenance therapy.
The 2005 renewal of the national drug strategy aimed to incorporate scientific evidence into drug policy.
In 2007, the federal government removed support for evidence-based harm reduction programs recommended by the WHO, the doctors said.
Wood has also questioned the effectiveness of anti-drug public service announcements.