Research Viewpoint: Criminalization of drug use or possession is rooted in racism

What you need to know

Drug prohibition (i.e., the banning of drugs) and criminalization (i.e., making using, selling or having drugs illegal) is costly and ineffective. It is time for these failed policies to end and to invest in the most heavily affected racialized communities. The evidence-based and ethically recommended policy proposal highlighted in this Research Viewpoint is from a group of international bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals.

They state that racial justice requires ending the “war on drugs”. This begins with decriminalizing the personal use and possession of small amounts of all drugs currently considered illicit. This would ultimately lead to full legalization and careful regulation of these drugs. Nonviolent criminal convictions and criminal records related to the use or possession of small quantities of current illicit drugs should also be expunged (i.e., completely erased), and those currently serving time should be released.


This Research Viewpoint is based on the article Racial Justice Requires Ending the War on Drugs. (2020).The American Journal of Bioethics. Available: Accessed March 11, 2021.


The “war on drugs” aims to protect people from harm and to promote health, but in practice, it has damaged many aspects of public health, significantly harming certain racialized communities. Racialized groups are disproportionately targeted, arrested, prosecuted, convicted, and incarcerated with longer sentences for drug offenses and crimes related to non-medical drug use. Sentencing can lead to long-term vulnerabilities and widen socio-economic disparities. This contributes to further disparities in the access and effectiveness of substance use disorder interventions.

Decriminalization and legalization would improve public health, reduce crime and reoffending, and lower unemployment and poverty rates. It would also save governments large sums of money and be a significant step towards ending racial injustice.

What ideas are the researchers presenting?

While health programs aim to reduce disease transmission within drug-using communities, prohibition makes this work less effective. It perpetuates stigma surrounding drug use, discourages users from seeking medical and non-medical help and supports, and creates more barriers to treatment for substance-related disorders. This leads to unsafe drug use and inadequate or incorrect knowledge about the real effects of drugs. Prohibition also takes funds away from health organizations and prevents the existence of evidence-based “safe supply” programs.

Unregulated markets lead to the production of unknown and inconsistent purity of drugs, the use of dangerous bulking agents and toxic additives, and the production of new psychoactive substances in an attempt to go around existing laws.

Decriminalization makes drug use safer and eliminates the harms and injustices associated with arresting and incarcerating drug users. In 2001, Portugal decriminalized all recreational drugs and focused on prevention, treatment, social reintegration, and other harm-reduction efforts. This reduced the harmful effects of arresting and incarcerating drug users, freed up resources in the criminal justice system, and lowered the rates of reported substance use disorders, overdoses, and drug-related HIV and hepatitis. Drug offenses, including trafficking and related crimes, did not increase. By 2017, Portugal’s drug-induced mortality rate among adults was substantially lower (four deaths per million) than the European average (22 deaths per million). Evidence from the Portugal model shows that when drug users do not fear criminal charges, they are able to seek out medical treatment, mental health care and social support programs. They can access evidence-based information about the harms involved in drug use and benefits of responsible drug use and treatment options for substance use disorders. A focus on harm reduction instead of punishment enabled programs to better engage and help young people, instead of having them go through the criminal system. Drug decriminalization increased effective delivery of housing, health and employment assistance to hard to reach and vulnerable populations. It also decreased the stigmatization of drug use and drug users.

How can this information be used?

A shift is required in society around how we think about drugs, moving away from the misunderstandings of the science of addiction. A comprehensive approach is required to tackle the deep-seated racial injustices associated with current drug laws, their biased enforcement, and the harms associated with illegal drug markets. Issues related to substance use or misuse should be approached through healthcare programs and social support, not prison time.

Policy-makers should pursue a combination of decriminalization and harm reduction for all drugs immediately. The researchers are not suggesting that all currently illicit drugs should be readily available to any potential consumer. However, they do suggest moving toward the eventual legalization and careful regulation of all drugs, including MDMA (ecstasy); psychedelic drugs, such as LSD and psilocybin; heroin and other opioids; methamphetamine; and powder and crack cocaine. The production, storage, handling, distribution, sale, and supply of currently illicit drugs should ultimately be legally regulated like other drugs such as alcohol, nicotine, and prescription medications.

The modes of access and barriers to accessibility must depend on the drug and its particular profile of benefits and risks and how it realistically would be used under different conditions. Policy-makers also need to develop racial and ethnic impact statements for any new regulations or changes to existing laws. Current and former drug users and their social networks must be involved in the revision of supportive policies and community-building initiatives in order to minimize the risks and potential negative impacts.

About the researchers

Brian D. Earp1, Jonathan Lewis2, and Carl L. Hart3

  1. Yale University, Connecticut, United States of America
  2. Dublin City University, Dublin, Ireland
  3. Columbia University, New York, United States of America


Brian D. Earp, Jonathan Lewis, and Carl L. Hart, with Bioethicists and Allied Professionals for Drug Policy Reform. Racial Justice Requires Ending the War on Drugs. (2020).The American Journal of Bioethics. Available: Accessed March 11, 2021.