In the 1990s, psychologists, therapists and psychiatrists working at treatment centres for people who use drugs in Uruguay began to question the country’s prohibitionist stance to drug use and its punitive approach to people who use drugs. Slowly, some authorities began to acknowledge the potential benefits of legalising certain substances. In 2013, in an effort to prioritise health and safety in communities, Uruguay became the first country globally to legalise the production, distribution and sale of marijuana. One major outcome of this was a downward trend in imprisonment for drug-related offences – something that was desperately needed to relieve severe overcrowding.

This landmark decision also marked a shift towards more progressive drug policies, leading to various state-supported healthbased programmes run by the National Drug Network. This includes the Aleros programme which connects people experiencing extreme social vulnerability and drug dependency to health and social support networks through a communitycentred approach. It also includes the Centros Ciudadela programme, which supports people who use drugs plus their families and close social connections. The Uruguay government allocated the National Drug Board an annual budget of around USD 795,900 for 2020-2024. This included funding increases for both the Centros Ciudadela and Aleros programmes. This additional investment has enabled 29 Ciudadela centres to open around the country, while the Aleros programme has doubled its coverage. This shift in approach is making a significant difference to individual lives, communities and public health.