6 Conclusions

This study is intended to inform policy makers, not to provide recommendations, except for a few about data and research.
Policy decisions reflect not only research findings but also the specific values, institutional arrangements and concerns of a
nation.

We find no evidence that the global drug problem was reduced during the UNGASS period. For some nations the problem
declined but for others it worsened and for some of those it worsened sharply and substantially. The problem generally
lessened in richer countries and worsened in a few large developing or transitional countries. The pattern for drugs was
also uneven. For example, the number of cannabis users may have declined but the sudden and substantial rise in cannabis
treatment seeking may suggest that the number of heavy users and harms have gone up. On the other hand, for cocaine a
roughly stable consumption was redistributed among more countries. In aggregate, given the limitations of the data, a fair
judgment is that the problem became somewhat more severe.

Between 1998 and 2007 policy changed in many ways. There was an expansion of efforts to help drug users, whether through
treatment or other harm reduction measures, at the same time that there was generally a tougher policy toward sellers. There
seemed to be a growing convergence of implemented policies, even if the rhetoric of international political debates did not
shift much.

The fact that policy changed substantially of course makes a policy assessment difficult but again we think a fair judgment
is that policy had no more than a marginal positive influence. Production controls had some local successes (for example in
Myanmar and Peru) but were unable to affect the availability of drugs globally; trafficking controls were no more successful.
Enforcement against local markets failed in most nations to prevent continued availability at lower price. Treatment reduced
harms both of dependent users and of society without reducing the prevalence of drug use. Prevention efforts, though broad
in many Western countries, were handicapped by the lack of programs of proven efficacy. Harm reduction has helped an
increasing number of countries but is focused on a narrow element of the drug problem.

The enforcement of drug prohibitions has caused substantial harms, unevenly distributed across countries. No matter how
well intentioned, there were predictable adverse effects to stringent enforcement; some of the effects were borne by nations
other than the one doing the enforcement. The challenge for the next ten years will be to find a constructive way of building
on these lessons so that the positive benefits of policy interventions are increased and the negative ones averted.