Background: Faced with high criminal justice, social, health and economic costs of criminalisation, many countries are considering alternatives to criminal sanctions for drug use and possession. This project analysed the latest international experiences of depenalisation, decriminalisation or legalisation of use and possession of all illicit drugs and put forward models that could be adopted by reform countries.
Methods: The project comprised a two-stage evidence review and interviews with local experts. Specifically, a targeted review was conducted of international decriminalisation models as of 2023 and 13 countries with alternative responses selected for detailed analysis (Czechia, Germany, Italy, Portugal, Spain, Slovenia, United Kingdom, Canada, USA, Costa Rica, Colombia, Uruguay, Australia). A realist review of 153 studies from the 13 countries and interviews with 17 international drug policy experts and practitioners was used to elucidate the latest evidence of the public health, social reintegration, public safety and criminal justice impacts. Data was triangulated and synthesised to produce an empirically derived set of models (extrapolating across countries) and evidence on the outcomes and advantages and disadvantages of each and any differences across countries/regions.
Findings: This research showed expanding interest in decriminalisation reforms in every continent of the globe. It further showed eight different models of decriminalisation involving all illicit drugs operate today, and that whilst most offer net gains over criminalisation, each has a distinct set of advantages and disadvantages. We hope this will bring to the fore key trade-offs and considerations about decriminalisation models and can foster more robust research and decision-making.