This paper reviews evidence of how drug control has been used to uphold colonial power structures in select countries. It demonstrates the racist and xenophobic impact of drug control policy and proposes a path to move beyond oppressive systems and structures. The ‘colonisation of drug control’ refers to the use of drug control by states in Europe and America to advance and sustain the systematic exploitation of people, land and resources and the racialised hierarchies, which were established under colonial control and continue to dominate today. Globally, Black, Brown and Indigenous peoples are disproportionately targeted for drug law enforcement and face discrimination across the criminal system. These communities face higher arrest, prosecution and incarceration rates for drug offences than other communities, such as majority populations, despite similar rates of drug use and selling among (and between) different races. Current drug policies have contributed to an increase in drug-related deaths, overdoses and sustained transnational criminal enterprises at the expense of the lives of people who use drugs, their families and greater society. This review provides further evidence of the need to reform the current system. It outlines a three-pillared approach to rebuilding drug policy in a way that supports health, dignity and human rights, consisting of: (1) the decriminalisation of drugs and their use; (2) an end to the mass incarceration of people who use drugs; (3) the redirection of funding away from ineffective and punitive drug control and toward health and social programs.

The war on drugs has failed in its stated goal of reducing drug use and sale, and has instead has resulted in a devastating trail of trauma, pain and suffering for families and communities, with communities of colour facing the harshest impact.

Globally, Black, Brown and Indigenous people are disproportionately targeted for drug law enforcement and face discrimination across the criminal system. They face higher rates of arrest, prosecution and incarceration for drug offences, despite similar rates of drug use and selling across races.

The war on drugs has provided the architecture within which racist and colonialist laws, policies and practices can operate. It must be replaced by strategies grounded in science, health, and human rights.

Our work to decolonise drug policy seeks to raise awareness of the racism and colonialism underlying international drug control and its impact on the health and human rights of individuals and communities, in order to begin to dismantle these destructive policies.

Overarching structural problems negatively affect access to health and harm reduction services. Racism and discrimination against Indigenous, Black and Brown people results in low household incomes, unemployment, food insecurity, poor housing and lower levels of education. This, in turn, results in worse health outcomes for these communities and in people from these communities disengaging or actively avoiding health services.

In the United States:

– People of colour, and most acutely Black people, are discriminated against at every stage of the judicial process: policing, pre-trial, sentencing, parole and post-incarceration.

– People of colour are not only incarcerated more often, but also for longer sentences. Almost half of all mandatory minimum sentences for drug offences are given to Hispanic people, and almost one third are given to Black people.

– As a result of racial disparities in policing and sentencing, Black men are incarcerated at five times the rate of white men.

In Australia and New Zealand:

– Structural inequalities negatively impact the health of Indigenous people.

– This inequality has persisted since the arrival of European settlers and the beginning of colonialism, with newly imposed health care systems focusing primarily to serve those of European descent.

– In Australia, Aboriginal and Torres Strait Islander people represented 28 percent of the prison population in 2019, while accounting for 3.3% of the general population. In New Zealand, Māori people comprised 52 percent of the prison population, but only 16.5 percent of the general population. This negatively impacts their health.

– Māori people consistently experience barriers when accessing health services, from discriminatory behaviour and inadequate information provision to practical barriers like costs and travel challenges, resulting in Māori people disengaging or actively avoiding health services.