Harm Reduction International (HRI) has monitored the use of the death penalty for drug offences worldwide since our first ground-breaking publication on this issue in 2007. This report, our 13th on the subject, continues our work of providing regular updates on legislative, policy and practical developments related to the use of capital punishment for drug offences, a practice which isa clear violation of international human rights and drug control standards. 

This year marks the beginning of a new approach to our flagship publication. Every edition of this report will provide key data and updated categories, as well as high-level developments at the national and international level. A deeper analysis of developments and trends will be published in the 2024 edition and on alternate years. The methodology used for both reports remains the same. HRI opposes the death penalty in all cases without exception.

The death penalty for drug offences: Global overview 2023

A few years ago, Howell Miller was in prison in New York State, walking laps around the track with a fellow-inmate he’d befriended, who happened to be a former U.S. congressman. Prior to the prison stint, Miller, a cheerful guy in his early fifties, had run a construction company and a serious marijuana operation, simultaneously. “I was a silent baller,” he told me. “Then one of my guys got caught with forty-four hundred pounds on a truck.” As Miller neared the end of a twelve-year sentence, he began hearing stories of people getting rich running weed shops: “I was thinking, Why the hell am I still in jail?” His ex-congressman friend, Anthony Weiner, told him on the track that day that the first dispensary licenses were going to be awarded to people who had marijuana convictions. “I thought, I’m gonna get out and look into that,” Miller said.

What Weiner had described was the Conditional Adult-Use Retail Dispensary program, or CAURD. It’s the flagship program of the Office of Cannabis Management (O.C.M.), the agency created, in 2021, to oversee the legalization of marijuana in New York. The state’s cannabis restrictions had been loosening for almost a decade, but that year the government passed a law that would have seemed unthinkable just a short while before. The governor at the time, Andrew Cuomo, had been pushed left on the issue during a primary challenge from Cynthia Nixon; after his reëlection, he found himself knee-deep in multiple scandals, and unusually pliable. The law not only made pot legal for adults; it also allocated forty per cent of weed-related tax revenue to communities where cops had made disproportionate marijuana arrests, and it set a goal of awarding half of all licenses to “social and economic equity” applicants: women, people of color, service-disabled veterans, distressed farmers, and residents of those overpoliced communities.

CAURD went a step further, mandating that the first licenses for the sale of recreational weed go to people who had, or whose family members had, a marijuana-related conviction. In the previous four decades, according to an analysis by the Legal Aid Society, police in New York had made more than a million marijuana arrests. Although weed is consumed in roughly equal proportions across the racial and economic spectrum, as recently as 2020 people of color were subjected to ninety-four per cent of marijuana arrests and summonses in New York City; arrests in the city were also much heavier in high-poverty areas. The idea for CAURD was plain: legal weed as reparations.

Legal weed in New York was going to be a revolution. What happened?

, which made Oregon the first state in the United States to remove criminal penalties for possession of a small amount of any drug, was and remains a historic turning point for the decriminalization movement. Sadly, the Oregon legislature has partially repealed the measure, creating new “drug enforcement misdemeanors” punishable by a term of supervised probation or up to 180 days in jail. Instead of taking steps to improve the health-based model, the legislature doubled down on criminal penalties, bowing to political pressure and an intense misinformation campaign by opponents, including the former chief of the prison system, business interests and law enforcement. Though this is undoubtedly a setback, Measure 110’s impact will reverberate for years to come.As the reform movement analyzes the 

and strategizes in other jurisdictions, some important lessons stand out:

Messaging and narrative building is a never-ending fight, even when evidence supports the policy shift

Promoting and defending a new reform policy is important well beyond the initial campaign.Whoever sets the narrative first has the upper hand, and it is important to publicize real impact and counter misinformation early on. Otherwise, any new policy can become an easy scapegoat for persistent societal problems, even with no evidence to show a causal link between them. This is precisely what happened in Oregon where M110 detractors took advantage of the valid frustrations with public suffering and blamed it on decriminalization:

The overdose crisis fueled by fentanyl has affected every area of the United States, regardless of varying drug laws, but Measure 110 has been blamed for the overdose crisis in Oregon. After 110, Oregon’s overdose death rate closely 

 the national average and remained lower than states that impose harsh criminal penalties for drug possession.Moreover, two longitudinal studies (available 

) found no association between Measure 110 and fatal overdoses.

Despite evidence that rates of homelessness were directly tied to Oregon’s 

 politicians and drug war sympathizers found 110 to be a convenient target to deflect public frustration with the increased visibility of unhoused people.

did not lead to an increase in crime rates

major crime rates in Oregon are declining

 – the new policy was blamed for the public’s anxiety about increased criminal activity.A driver of this perception was public drug use, which has risen in tandem with increased homelessness.Opponents argued that Measure 110 caused an increase in drug use, which resulted in an increase in homelessness.Though this politically toxic message was not born out by the evidence, it was a key factor in the push to reinstate criminal penalties.

Implementation of decriminalization is as important as establishing the policy

Reshaping existing systems to implement a new policy is critical to the policy’s success.In Oregon, state officials were slow to implement key components and undercut the full potential of Measure 110 in a number of ways:

The Oregon Health Authority (OHA) provided 

, which resulted in significant delays in allocating funding for needed services.We know from successful health-based models how critical it is for decriminalization measures to be implemented in parallel with expanded and fully-funded health and recovery support services. Unfortunately, the delay in Oregon impeded access to needed services.

The state did not educate the public about the drug treatment screening hotline that the measure created, and failed to provide training to law enforcement, many of whom were opposed to Measure 110.Law enforcement can sabotage the policy in both obvious and subtle ways if they are hostile to it, and it was important to educate them about the benefits of the policy and ensure they are not obstacles to successful implementation.

Implementation of Measure 110 unfortunately coincided with a number of other crises:

The COVID-19 pandemic, which had ripple effects throughout Oregon, especially for evictions, housing policies, and taxing an already overburdened health system.

The proliferation of fentanyl across the United States, starting in 2019 on the West Coast (including Oregon), led to a sharp increase in overdose rates.

National fearmongering concerning crime was exploited by longstanding opponents of drug policy reform.

Despite setbacks, M110 will have lasting impacts for the decriminalization movement

 for thousands of people by decreasing arrests and barriers to jobs and housing that result from those records.

increased access to and engagement with services

the number of people accessing the addiction services and social supports they need, including substance use disorder treatment, housing services and overdose prevention services.The services created by M110 will stay in place even after drug possession is recriminalized.

There has been a decrease in criminal penalties for drug possession even after recriminalization – cutting the potential maximum sentence in half - compared to the state of the law before Measure 110.

Criminal penalties are not the answer to problematic drug use.Decades of research and experience have made this clear. Politicians who, in an effort to find cover from public anger, turn to the criminal system for answers will quickly relearn this lesson. Though the legislation will prevent the full benefits of decriminalization from being realized, M110 remains an important step in taking drug possession out of the criminal system. The experience in Oregon also highlights the need for safer supply, drug consumption facilities, and why legal regulation based on health and human rights is essential for a true health-based approach.The legacy of Measure 110 is far from over – it will continue to grow and the lessons learned from it will strengthen the movement to reduce the role of the criminal legal system in drug policy.

Backpedalling on progress: Understanding Oregon’s U-turn on drug decriminalisation

“The recent national election has seen a change in administration where the party of the prime minister had campaigned for much stricter drug policies,” says Gloria Lai, regional director of Asia for the International Drug Policy Consortium said. “The government has since announced that new laws regulating the cannabis market are expected to pass in mid-2024, which will aim to support only medical use of cannabis, with restrictions on the sale of certain cannabis products and related equipment.”

As Lai explained, this is highly likely to have an impact on the thousands of businesses that have made weed their income over the past 18 months. She has concerns that it will shut out small business owners and local farmers who have been able to make a livelihood from this. The market, she fears, will instead be left to elite or large organizations to profit.

In addition, potentially millions of Thai people, who may not be able to obtain a prescription, could either lose access or face harsh criminalization once again.

With economic factors no doubt a key factor in the initial decriminalization decision, the past year would have been the perfect opportunity for the government to study health and social outcomes of the policy, obtaining data to inform its next steps. However, Lai is unaware of any such studies being carried out.

The motives behind this re-regulation are as murky they were for the initial decriminalization, though Prime Minister Thavisin told 

 in September 2023 that drug problems had been “widespread lately.”

Inside Thailand’s U-Turn on cannabis decriminalization

In yet another dramatic development for minoritised communities in Uganda —still reeling from the shock of the 

, on 2nd February 2024 the President signed the Narcotic Drugs and Psychotropic Substances (Control) bill into law, another draconian piece of legislation that threatens the health and wellbeing of Ugandans. 

The Anti-Homosexuality Act imposes life imprisonment and even death for those convicted of homosexuality and ‘aggravated homosexuality’, whereas the Narcotics Law penalises the possession of illegal drugs with over 15 years in prison (and life imprisonment for people involved in supply). These laws target marginalised groups who are already made disproportionately vulnerable to the harms associated with drug use, HIV, and other illnesses. Instead of promoting much-needed access to support and care, the new law pushes these communities away from health and social services that are essential to manage drug dependence, prevent HIV transmission and AIDS, and support people to be well and live productive lives. Also concerningly, these laws are emboldening parts of Ugandan society to justify violence and exclusion. As such, both laws amount to an assault on public health and, if implemented, will result in dramatic increases in imprisonment, with detrimental knock-on effects not only on those criminalised but all Ugandans.

The law’s proposed stiff penalties on people who use drugs will also drive them further underground, making access to health and justice an even greater obstacle course. Recent data by the Uganda Police indicate that every year there are approximately 3,000 cases related to narcotics recorded. It is widely known that contact with the criminal justice system greatly depends on police discretion. People who use drugs tend to be arrested based on their appearance and the assumption that they are perpetrators of harm and deleterious social habits. As such, greater punishment spells intensified stigma and arbitrariness in the application of the law.

The Uganda Harm Reduction Network’s preliminary analysis of the new law identifies a range of challenges, including the criminalisation of the possession of plants and substances (including cannabis and khat), as well as the possession of drug use utensils, which are essential for harm reduction. Hefty fines and/or long imprisonment for victimless behaviours could become the norm.

The Act perpetuates and intensifies the criminalisation of people who use drugs, prioritising criminal justice responses over care and assistance. In this way, the new law threatens the provision and access to harm reduction services and fuels health risks among people who use drugs in all their diversity. Furthermore, the threat of punishment has spread fear and will further drive community members underground, impeding important civic organising and democratic accountability.

It is based on this background that the Uganda Harm Reduction Network, the national network of people who use drugs in Uganda calls for international partners that give support to Uganda, including the European Union, UN agencies (e.g. UNODC, UNAIDS, WHO, UNDP), the Global Fund, PEPFAR/CDC, civil society organisations (e.g. Amnesty International, Human Rights Watch), and all bilateral and multi-lateral development partners to publicly condemn these draconian pieces of legislation that impose long term imprisonment to already marginalised communities of people who use drugs.Communities experiencing state violence and neglect need access to health care services, not incarceration.

We also urge our government to support embrace and fulfil the principle of 

committing to withdraw these pieces of legislation and initiate a process of consultation and redrafting that involves affected communities and service providers.

For more information visit the links below:

New narcotics law is going to increase apprehension

Expert: new Narcotics bill risks exacerbating drug-addiction issue

Anti-Homosexuality Act starts to bite as NGOs operate on edge

Uganda's new Narcotics Law will undermine access to healthcare for people who use drugs

DEA considers rescheduling cannabis: What this means for U.S. and global policy

The Drug Enforcement Administration has confirmed it is reviewing the classification of cannabis under the Controlled Substances Act, just days before the first public acknowledgement of its medical use by the Department of Health and Human Services.

Amid an “unprecedented” situation, speculation is rife around whether the U.S. is finally heading for a shift in policy at a federal level. But one thing experts do agree on is that any decision on cannabis policy is likely to be based on politics, rather than public health.

And yet, it will do little to address the harms caused by decades of this hard-line approach, according to Ann Fordham, executive director of the International Drug Policy Consortium.

“The devastating harms of U.S.-led global cannabis prohibition, such as the criminalization and incarceration of millions of people for cannabis-related activities, would remain entirely unaddressed by domestic rescheduling,” she says in an email.

“Furthermore, advocates for drug policy reform within the U.S. have called on President Biden to take steps to completely remove cannabis from the domestic schedules, noting that a move to Schedule III does not mean cannabis is decriminalized, as per his campaign promise, or lessen the harms of federal prohibition.”


Ghana: Law students urged to guard against inimical drug policies, legislations

Accra, Jan. 30, GNA – Ghanaian Law students have been urged to help prevent drug policies, measures and legislations that work against the rehabilitation of substance abusers. 

The students were asked to not only play roles in the prevention of the use and circulation of drugs (cocaine, marijuana, tramadol, etc.) but also be critical of incarceration of abusers and lack of rehabilitation centres. 

The call was made by drug policies and legislations advocates at a day’s hybrid workshop for tertiary students and faculty members in Ghana by POS Foundation on the theme: “Substance Use and Prevention: A Comparative Dialogue between Ghana and the USA’s Drug Policy.” 

Participating universities were GIMPA Law School, Ghana, Adler University, Chicago, Illinois and Columbia University, New York and Fordham University, New York and Students for Sensible Drug Policy (SSDP) with the students sharing their perspectives.

Madam Maria-Goretti Ane Loglo, Lawyer and IDPC Consultant for Africa, said the people languishing in jail because of drug use had been the younger population, a situation we had to avert because there had been lack of jobs to engage them.

“As a country we also need to revisit the fines given to offenders. The fines are very high and many of the people cannot afford. The State must resource the Fund to help in rehabilitation and put up rehabilitation centres that are accessible and less expensive,” she said

Ghana: Law students urged to guard against inimical drug policies

I hope this letter finds you in good health and high spirits. I am writing to you with great concern regarding the proposed Narcotic and Psychotropic Substances Bill that is currently under your consideration.

As a concerned citizen deeply invested in the well-being and progress of our beloved Uganda through the Uganda Harm Reduction Network (UHRN), I am compelled to express my apprehensions and urge you to desist from signing this bill into law.

While I understand the importance of addressing the challenges posed by drug abuse and trafficking, I am concerned that certain provisions in the proposed bill may have unintended consequences for individual freedoms, public health, and the overall development of our society.

The global community has increasingly recognized the need for balanced and evidence-based drug policies that prioritize harm reduction, rehabilitation, and human rights. According to the Uganda police annual report of 2022, 2,797 cases of narcotics/ drugs were reported countrywide, yet of that figure, 1,816 cases were taken to court and only 367 cases secured convictions, most of which were minor offences.

By measure of the Penal Code Act, an offence that attracts such paltry convictions needs deeper scrutiny to find ways of reducing them rather than rolling out tough laws that may be detrimental.

So, the concept of decreasing harm should be important to public policy, yet expressly trying to remove drug-related harms through legislation has never worked in drug control anywhere in the world. In passing the bill, parliament has an assumption that all drug use is ‘abuse’ and that only immediate abstinence is acceptable.

This is counterproductive and prevents harm reduction from being a drug policy priority. So, I respectfully request you, Mr President, consider the following points before making any decisions on the Narcotic and Psychotropic Substances Bill:

Some provisions in the bill may pose a threat to individual privacy and freedom. It is crucial to ensure that any legislation preserves and protects the fundamental rights of Ugandan citizens.

As a result, criminalizing drug use may dissuade people from seeking medical care for drug-related health problems, infringing on their right to health. Punitive measures can stymie harm reduction attempts by making it harder for people to get clean needles, overdose prevention measures, and other health services.

Emphasizing rehabilitation and treatment over punitive measures has proven to be more effective in addressing drug-related issues. Investing in healthcare, education and support services can contribute significantly to reducing the demand for illicit substances.

What we need are diversion programs that redirect people who use drugs away from the criminal justice system into community-based rehabilitation programs. In fact, from my experience at UHRN, such centres further need to be allocated resources and protection to provide accessible and evidence-based treatment for individuals with substance use disorders.

It would be beneficial to align the proposed legislation with international best practices in drug policy. Learning from the experiences of other nations can help in crafting effective and humane policies.

So, since harm reduction approaches aim to minimize the negative consequences associated with drug use, engaging in open and inclusive consultations with various stakeholders, including health professionals, legal experts, civil society organizations and affected communities, is crucial to ensuring a comprehensive and well-informed approach to drug policy.

Mr President, you may not be aware but people who inject drugs need access to clean needles and syringes to reduce the transmission of blood-borne infections, such as HIV/Aids and hepatitis.

I also wish to inform you that organizations such as UHRN regularly conduct public awareness campaigns and educational programs to disseminate information about the risks associated with drug use, safer consumption practices, and harm reduction strategies. These outreach programs have saved hundreds of thousands of people who inject drugs.

Therefore, it is on this background that I advocate for a law that prioritizes public health over punitive measures, decriminalizing personal drug use and possession while focusing on diversion and treatment options.

Mr President, I understand the challenges you face in addressing complex issues such as drug abuse and trafficking. However, I believe that a balanced and evidence-based approach will be more successful in achieving the desired outcomes without compromising the rights and well-being of our citizens.

I appreciate your attention to this matter and trust that you will give due consideration to the concerns I have raised. Your leadership in promoting policies that prioritize the health, welfare, and human rights of our people will undoubtedly contribute to the continued prosperity of our great nation.

Thank you for your time and consideration.

Uganda: Dear Mr President, here’s my appeal to resist signing the Narcotic bill

Statement delivered by Volker Türk, UN High Commissioner for Human Rights at the 

8th Brandenburg Forum on Drugs and Development Policies

, organised by the Global Partnership on Drug Policies and Development (GPDPD) (commissioned by the German Federal Ministry for Economic Cooperation and Development - BMZ, and implemented under political patronage of the Commissioner of the Federal Government for Drug and Addiction Policy) and co-hosted by the Government of the Netherlands, the Norwegian Ministry of Health and Care Services, the Transnational Institute (TNI), and the International Drug Policy Consortium (IDPC).

From deaths and ruined lives to violent crime and mass incarceration, the toll of the global trade in illegal narcotics is unbearable. Drug use has taken many lives.

But so have poorly constructed drug control policies.

Punishing people who use drugs with jail and criminal records adds to their suffering. It results in stigma and social exclusion; makes it more difficult for drug users to function in the legal economy; and drives them deeper underground – beyond the reach of help.

 underground, where they may connect with networks trading arms and trafficking people. This fuels far greater criminality.

My Office recently issued a report on human rights challenges related to the world drug problem. It found that the persistence of 

 creates serious challenges to human dignity and contradicts international human rights standards.

punitive drug control laws and law enforcement practices

 are among the main obstacles preventing people from entering drug treatment programmes when they need to. In 2021, only one in five people suffering from drug-related disorders was in treatment for drug use globally, with huge disparities in access to treatment around the world.

Criminalization and the so called ‘war on drugs’ approach have failed to curb drug use. And they have not deterred drug-related crime. Instead, the so-called ‘war on drugs’ has 

, with sharply escalating use of lethal force in drug-related law enforcement in several countries – alongside evidence of multiple and serious human rights violations in some cases. These range from unnecessary and disproportionate use of force, to arbitrary detentions and even extrajudicial killings.

The so called ‘war on drugs’ has been accompanied by 

 for drug-related convictions worldwide, contrary to international human rights law. The recorded number of people executed for drug-related offences more than doubled in 2022 compared to 2021 – and this does not include countries which keep the number of people whom they execute a secret.

 – disproportionately people from minority communities, and young people from poor backgrounds.

Morally and practically, as our report demonstrated, the ‘war on drugs’ approach has failed. The world drug situation remains very concerning, but 

treating people who use drugs as criminals is not the solution

The report's recommendations aim to inspire action in view of next year's midterm review of the 2019 Ministerial Declaration on persistent and emerging challenges related to the world drug problem.

That mid-term review is a key moment. As we look back, to take stock of results to date, we will also be looking forward – planning what needs to be covered by 2029, and how that can be done. It is also an occasion for States to renew the Ministerial Declaration's strong commitment to human rights, as part of transformative change to address the global drug situation.

At the core of addiction is often the gnawing feeling that one’s life is unbearable. We need to address the underlying social and economic factors of ever increased drug use, by tackling social inequalities, and promoting social justice.

We need measures that can take control of illegal drug markets, such as responsible regulation that can eliminate profits from illegal trafficking, criminality and violence.

We need inclusive policies that ensure access to medical care and to harm reduction services, with measures that address the specific needs of women. All forms of treatment for drug use disorder must be voluntary, and discrimination by law enforcement against people of African descent, Indigenous Peoples and other marginalized populations must be ended.

I also strongly encourage all authorities to engage with people who use drugs, and affected communities, to ensure that drug policies are based on evidence, and that they are properly implemented to improve the lives of the millions of people who are affected.

The Brandenburg Forum is a leading force in the global movement to ensure that drug policies promote more effective solutions, by focusing on people and their rights.

I applaud your initiatives to advance cross-national dialogue focusing on public health; on human rights; and on inclusive and sustainable development – in line with the 2030 Agenda for Sustainable Development, an ambitious, detailed and very necessary human rights-based commitment.

Several countries have begun to approach drug usage as a public health and human rights issue – applying evidence-based and gender-sensitive harm reduction approaches, and decriminalizing the use of some drugs.

 countries to take decisive steps in this direction, by ensuring that their drug policies focus on support – not coercion and fear.

Drug policies will be more effective with a human rights approach, UN Human Rights Chief says

New South Wales (NSW) police drug-detection dogs incorrectly detect illicit substances on patrons 75 per cent of the time, raising questions about the efficacy of enforcement as the state’s festival season starts.

The startling figures come as a report from the Law Enforcement Conduct Commission reveals the police are falling short on self-imposed initiatives designed to ensure the law was followed when undertaking strip-searches.

Under NSW law, police can undertake either general or strip-searches if they suspect someone has illicit drugs in their possession. Sniffer dogs are used by police to sense drugs and screen for suspicious behaviour.

Data obtained through the parliament by NSW Greens MP Cate Faehrmann shows of the 94,535 general and strip-searches undertaken from 2013 to June 30 this year, 70,913 yielded no illicit drugs, a success rate of just 25 per cent.

Criminal justice

The death penalty for drug offences: Global overview 2023

Legal weed in New York was going to be a revolution. What happened?

Backpedalling on progress: Understanding Oregon’s U-turn on drug decriminalisation

Inside Thailand’s U-Turn on cannabis decriminalization

Uganda's new Narcotics Law will undermine access to healthcare for people who use drugs

DEA considers rescheduling cannabis: What this means for U.S. and global policy

DEA considers rescheduling cannabis: What this means for U.S. and global policy

Ghana: Law students urged to guard against inimical drug policies, legislations

Ghana: Law students urged to guard against inimical drug policies

Uganda: Dear Mr President, here’s my appeal to resist signing the Narcotic bill

Drug policies will be more effective with a human rights approach, UN Human Rights Chief says

Australia: Drug-detection dogs are wrong more than right, data reveals