NHS Doctor Advocates for Evidence-Based Drug Policy Reform
As healthcare professionals, doctors are trained to follow scientific evidence rather than political ideology. This principle is why NHS doctor Holly Tarn believes the Green Party's controversial drug decriminalisation policy deserves serious consideration, despite recent attacks from political opponents.
Political Attacks on Drug Policy Proposals
In the lead-up to the Gorton and Denton by-election, the Green Party's stance on drug decriminalisation faced fierce criticism. Labour leader Sir Keir Starmer condemned what he called the "legalisation" of drugs as "irresponsible and reprehensible," warning it would "shatter lives, increase antisocial behaviour, and see drug use running rife."
Doctor Tarn acknowledges that without her medical background, she might find such rhetoric persuasive. Most people have witnessed the damage drugs inflict on individuals, families, and communities. The fear surrounding drug use is genuine, and the harm caused is substantial.
Compelling International Evidence
However, the evidence presents a different picture. Comprehensive research demonstrates that decriminalising drug possession for personal use leads to significantly better public health outcomes. These include fewer HIV transmissions, reduced fatal overdoses, and improved access to treatment services.
Portugal serves as the most frequently cited example. After decriminalising all drugs for personal possession in 2001 and investing heavily in treatment and harm-reduction services, the country witnessed dramatic declines in HIV infections among people who inject drugs. The nation also experienced sustained reductions in overdose deaths. Crucially, drug use did not explode, though some forms of consumption—particularly cannabis—rose in line with broader European trends.
Similar patterns emerge wherever decriminalisation is paired with robust public health investment. Switzerland introduced Heroin Assisted Treatment, prescribing medical heroin under supervision, which led to dramatic reductions in HIV transmission, overdoses, and drug-related crime. Canada and the Netherlands have recorded comparable success stories.
Clarifying Critical Terminology
Doctor Tarn emphasises the importance of terminology, noting she uses "decriminalisation" (what the Greens propose) rather than "legalisation" (a term many opposing politicians mistakenly employ). These terms are not interchangeable. Legalisation means regulating drug production and sale through a lawful market, while decriminalisation removes criminal penalties for personal possession and use while keeping supply and trafficking illegal.
This distinction is fundamental rather than trivial. Given Sir Keir Starmer's background as former Director of Public Prosecutions, it seems unlikely this difference is unclear to him. Framing decriminalisation as "legalisation" conjures images of freely available, marketed, normalised drugs—a scenario most people understandably fear.
Decriminalisation does not create a commercial market or remove supply restrictions. It does not mean drugs become available to "children on the street." Instead, it means diverting individuals caught with small amounts for personal use to health services rather than criminal courts.
The Failure of Current UK Policy
The evidence indicates that the UK's criminalisation approach is failing. In 2024, there were 5,565 deaths related to drug poisoning registered in England and Wales—the highest number since records began. Recent government surveys show that among people who inject drugs in England, sharing and re-use of injecting equipment has risen to its highest level in a decade, signalling ongoing risks for blood-borne viruses like HIV and hepatitis C.
Despite decades of punitive policy, the harms persist—a stark reminder that criminalisation alone does not reduce use, protect health, or save lives.
Frontline Medical Experience
As a resident doctor in the NHS, Doctor Tarn witnesses the consequences of failing drug policy weekly. She treats patients with abscesses from unsafe injecting, endocarditis from contaminated needles, and overdoses that could have been prevented. She observes the revolving door of emergency admissions.
During a recent outreach shift with a homeless health team in Brighton, medical professionals encountered a young man in sheltered accommodation barely able to move, drenched in sweat, shaking, and withdrawn. His temperature exceeded 40°C, and he appeared septic, yet he resisted medical assistance for 45 minutes before agreeing to enter an ambulance.
This deep mistrust is no accident—it is shaped by how society chooses to treat drug use. Doctor Tarn regularly observes patients reluctant to seek help because they fear judgement or criminal consequences.
Reframing Addiction as Health Issue
Addiction is not a moral failing but a chronic health condition shaped by trauma, poverty, mental illness, and social inequality. Society wouldn't threaten prison for a relapse of depression, yet for drug dependence, punishment remains the first response.
Criminal records do not cure addiction. Prison does not treat trauma. Stigma does not prevent overdose.
Decriminalisation is not equivalent to endorsing drug use. It does not represent a free-for-all. Rather, it means recognising that the "war on drugs" has often been a war on vulnerable people.
As doctors trained to follow evidence rather than ideology, when research demonstrates that criminalisation exacerbates harm—driving people away from services, increasing unsafe practices, and deepening inequality—medical professionals have a responsibility to speak out.
Society can repeat tough-sounding slogans, or choose policies that reduce harm, save money, and most importantly, save lives. As someone on the NHS frontline, Doctor Tarn knows which approach is more responsible.
