Pharmacy sign

This blog makes the case for the legalisation and regulation of drugs and explains how it can control the availability of drugs. This piece is an edited extract of Transform’s Debating Drugs guide, which addresses common concerns about the legal regulation of drugs including:

More than 50 years of prohibition, and over a trillion dollars spent on enforcement, have failed to prevent a dramatic rise in illegal drug use, with over 284 million people using drugs each year worldwide today [1]. This is hardly surprising given that research consistently shows criminalisation does not deter use. Legal regulation simply means the availability of drugs is controlled by governments rather than organised crime groups and unregulated sellers.

Criminalisation does not deter people from using drugs now.

  • Comparative studies of drug laws around the world show no link between harsh enforcement and lower levels of use [2,3]. The theory that criminalisation has a significant deterrent effect, which underpins the policy of prohibition, is not supported by evidence

  • In the Netherlands, where the possession and retail supply of cannabis is legal in practice, rates of cannabis use are almost the same as the European average [4]

  • When Portugal decriminalised the possession of all drugs in 2001, drug use did not rise dramatically, as some feared [5, 6]

  • In many countries, tobacco use is half what it was 30 years ago [7]. This reduction has been achieved without blanket bans or criminalising smokers; it is the result of health education and stricter market regulation, only possible because tobacco is a legal product

  • Levels of drug use are often directly equated with levels of drug harm, but this can be misleading; most drug use is non-problematic. Rather than narrowly focusing on reducing use, policy should seek to reduce overall health and social harms [8]

Legal regulation will not increase the availability of drugs.

  • Legal regulation means controlled, not increased, availability, with tight controls on what can be sold, where it can be sold, and to whom. Under prohibition, there are no such controls and drugs are more available than ever

With legal regulation, there can be restrictions on how commercial the market becomes.

  • Drug markets do not have to operate along commercial lines. Options exist for state-run institutions or non-profit organisations, to manage the drug trade effectively, in ways that remove the financial incentive to increase or initiate use, and can ensure a diverse and equitable market where commercial options are pursued

  • We can learn from the mistakes of alcohol and tobacco control. Levels of alcohol and tobacco use are the result of decades of commercial promotion, often in largely unregulated markets. With currently illegal drugs, we have a blank slate: we can put in place optimal regulatory frameworks from the start, controlling all aspects of the market

  • Stricter tobacco regulations have seen a decrease in smoking rates across much of the world in recent decades

  • We have a choice: the drug trade can be controlled by organised crime groups, or by doctors, pharmacists and licensed retailers. There is no third option in which drug markets disappear

  • Criticisms of some commercial companies are entirely legitimate. However, unlike organised crime groups, they are regulated by government bodies, pay taxes, are answerable to the law, unions and consumer groups, and do not use violence in their daily business dealings

Drug use has been rising since drugs were made illegal.

  • Drug use has risen globally for more than half a century, but inevitably fluctuates up and down to some degree for different drugs, jurisdictions, and demographics. The current number of people who use illegal drugs is so high that it constitutes a significant public health challenge, and crime and security problems related to the illegal trade. Even where drug use is declining for certain drugs or populations, prohibition leaves too many people using unregulated drugs in unsafe ways, and a vast market in the hands of organised crime groups

  • Research consistently shows that rates of drug use are primarily driven by changing cultural, social or economic trends, not by the intensity of enforcement [9]

  • Moving towards regulated drug markets will free resources to be redirected into health interventions we know can reduce drug related health harms, including evidence based prevention and risk education, harm reduction and treatment

For more insight into making the case for legal regulation, please see our Debating Drugs guide.


  1. UNODC, World Drug Report 2022 (United Nations publication, 2022).

  2. Degenenhardt, L. et al. (2008) ‘Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys’, PLoS Medicine, vol. 5, no. 7.

  3. European Monitoring Centre for Drugs and Drug Addiction (2011a) ‘Looking for a relationship between penalties and cannabis use’.

  4. European Monitoring Centre on Drugs and Drug Addiction (2013) ‘Prevalence maps — prevalence of drug use in Europe’.

  5. Transform Drug Policy Foundation (2021) ‘Drug decriminalisation in Portugal: Setting the record straight’, p. 4.

  6. European Monitoring Centre for Drugs and Drug Addiction (2011b) ‘Drug policy profiles — Portugal’, p. 20.

  7. For example, the adult smoking rate in England was 20% in 2010, compared to 39% in 1980. Health and Social Care Information Centre (2013) ‘Statistics on Smoking: England, 2013’. smok-eng-2013-rep.pdf

  8. For more information on reducing harm, see ‘Will drug use rise? Exploring a key concern about decriminalising or regulating drugs’.

  9. See references 2 and 3.