The so-called war on drugs has failed. In the last century, countries have increasingly attempted absolute prohibition of drug use, often via penal measures. Despite global action, these policies have not deterred drug use: we have reached record levels of “abuse, illicit cultivation and production and manufacture of narcotic drugs and psychotropic substances”, as acknowledged at the 2024 UN Commission on Narcotic Drugs. Drug trafficking networks have become increasingly sophisticated and violent, and deaths related to drug use have increased.