This multi-criterion decision analysis publication convened a panel of 17 experts on drug harms, addiction, criminology and drug policy, and with 2 facilitators they appraised alternative regulatory regimes for alcohol and for cannabis.1 For both alcohol and cannabis, state control was the preferred approach, and absolute prohibition the least favoured – with decriminalisation and free-market approaches in the middle.1 To better understand the judgements, and how specific criteria impact decisions, 27 different criteria were ranked individually based on how they would sway the overall preference for the regime – this is shown on the slide.1 For alcohol, the factors ‘avoidance of criminalizing users’, ‘generation of state revenues’, ‘avoidance of a criminal industry’, and ‘better community cohesion’ contribute approximately 75% of the overall 35-point difference favouring state control over prohibition.1 For cannabis, the four strongest factors favouring state control over prohibition were ‘improved community cohesion’, ‘reduced harms from more harmful substances (e.g. synthetic cannabinoids or “spice”)’, ‘medical use’, and ‘family cohesion’.1 Using this deconstructing approach, the complex issues of drug regulation were split into many smaller discussions around which it was possible to find a broad consensus.1
Public policy choices – health versus criminalization
