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Do criminal penalties reduce drug use? What if a health-led approach delivered better outcomes, at lower cost, and with safer communities? On this episode of #ConsiderThis Melisa Idris speaks with Professor Alison Ritter, Director of the Drug Policy Modelling Programme at the University of New South Wales, Australia. Prof Ritter was a speaker at the Drug Policy Summit Malaysia on 4-5 November 2025.
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00:00Hello and good evening. I'm Melissa Idris. Welcome to Consider This.
00:14This is the show where we want you to consider and then reconsider what you know of the news of the day.
00:19I'm here at the Drug Policy Summit Malaysia where experts and policy makers are discussing
00:26if and how the world should rethink its approach to drugs.
00:31Now joining me on the show to discuss this further, to explore what's changing and what's not in global drug policy,
00:38I have with me Professor Alison Ritter who's Director of the Drug Policy Modelling Programme
00:43at University of New South Wales in Australia.
00:46Alison, thank you so much for being on the show with me today.
00:49So I think for decades now, as you must know, also the global drug policy regime has been shaped by the war on drugs,
00:59the so-called war on drugs.
01:00But we're here today at this summit where we're rethinking or maybe even considering the potential for reform.
01:07We have countries around the world experimenting with decriminalisation or legal regulation.
01:14Do you think we're now witnessing a real paradigm shift when it comes to prohibition?
01:22Is that the trend, the thinking nowadays?
01:26Thank you very much for having me.
01:29I think there's definitely a global trend away from strict prohibition.
01:35There are more than 50 countries around the world that have changed the way in which they respond to drug use.
01:42And we're seeing many places recognising that the economic cost of treating people who use drugs as criminals
01:54is significant and not worth it.
01:59It's not a good economic investment to treat people who use drugs as criminals.
02:03It is much better to provide them with information, harm reduction, health care, social support.
02:11That's much less costly.
02:13Health care is cheaper than policing.
02:16And it's more effective.
02:18So when you combine less cost for government and a more effective approach,
02:24it's kind of a no-brainer to start to think about drug use as a health and social issue.
02:31When you say it's more effective, talk to me a little bit about that.
02:35So with 50 over countries that you said that are changing their policies around their drug policies,
02:42the outcomes, what do we know about that?
02:44What does the latest data tell us about what is actually working?
02:48Yeah, so this is for people who are using drugs.
02:51We know that providing a treatment response for people who are dependent on drugs,
02:57about a third to a quarter of people stop using altogether.
03:02A third go back to using drugs.
03:07And a third use less or use less harmfully.
03:10So that's, and generally we know those are the outcomes from providing treatment.
03:14Sending someone to prison, 100% of people resume drug use, almost.
03:22I mean, there are the rare exceptions.
03:24But sending someone to prison is not a way of changing someone's behaviour.
03:30For the time they're in prison, they may use less or none, depending on your prison system.
03:36Many prisons have a lot of drugs in them, as we know.
03:39But when you come out of prison, you haven't learnt any new skills for how to be in the world without using drugs.
03:47All you've learnt is that you've done something wrong, you've been criminalised, you're likely not to get a job,
03:53you're likely to have problems with your family.
03:56None of that helps with dealing with drug use.
03:59So we have that evidence now.
04:02That data has been researched, that's evidence-based.
04:07Has that changed the conversation?
04:10Has that changed policies?
04:12Yeah, well, I mean, and I think Malaysia is a really good example,
04:16where for the last three years there have been really positive conversations
04:20with the Ministry of Health, with the AADK, with the police,
04:26looking for ways to improve things and try and not have such a criminalised response to drug use.
04:36So even here, this is a really good example of that conversation evolving.
04:40When you work with governments, with stakeholders, with law enforcement, may I ask,
04:48when you present these clear evidence of improvements, of effectiveness, of harm,
04:57when criminalising people who use drugs, do you find that it changes their minds?
05:05Or is it still quite difficult to move away from punitive models?
05:11Well, I think evidence is really important, but it's not the thing that changes people's minds.
05:19So we can have all the evidence in the world about something,
05:23but that doesn't mean policy makers are going to implement that policy.
05:29So you need more than evidence.
05:31Evidence is an ingredient, but it's only one.
05:34I think the other ingredients are to do with values and what society values as important,
05:41like a compassionate response, a humane response.
05:46So values are really important in this discussion.
05:50And then the other part is about talking to people about what they're afraid of.
05:55So there are real fears for public safety and public security.
06:00And I think people don't necessarily understand that using drugs is not inevitably going to cause a public safety problem or a lot of disorder.
06:14So you need to work with the fears that people have, you need to work with values, and you need the evidence.
06:20So we've got the evidence.
06:21Now it's about working with people's fears.
06:25I didn't know whether to bring this up.
06:28I didn't know whether this was semantics, but I came across the importance of making that distinction between evidence-based and evidence-informed.
06:38Can you talk to me a little bit about that?
06:40So evidence-based policy originally came from medicine, where they were trying to teach doctors not to do what their gut instinct said, but to follow the evidence.
06:52So there was evidence-based medicine.
06:53That's how it began.
06:54And then people talked about evidence-based policy.
06:57But I think we've recognised that you need more than evidence.
07:03So evidence-informed policy is the new term, and that recognises values and the importance of dialogue.
07:11And it's worth saying there's not necessarily just one right answer here.
07:15I think drug policy is complicated, and it's not easy, and it takes a lot of conversations to move things along.
07:24Where have you seen the benefits of dialogue, of engaging in conversation move the needle when it comes to drug policy?
07:32Have you seen that?
07:33Yeah, so there's some really good examples from around the world.
07:37I mean, one example I would give is Ireland, where they held a citizen's jury.
07:42So a citizen's jury brings everyday people in, and they're given a whole lot of information.
07:47They get to ask questions.
07:48They have expert witnesses, and then they write a consensus statement afterwards about what the drug policy should look like.
07:57And Ireland has moved forward.
08:01They've also done it for abortion as well in Ireland.
08:04Wow, that's very progressive.
08:06It's very progressive.
08:07So there's Ireland.
08:09New Zealand has just had a process in relation to illicit drugs, where they've had a dialogue amongst everyday people.
08:17Because I think if everyday people can kind of better understand the issues, politicians are more likely to act.
08:30What is it like in Australia, where you're based?
08:33It varies.
08:35So we have one state in Australia that has effectively legalised cannabis,
08:40and they have also removed all criminal penalties for drug use.
08:44And that was the result of a parliamentary inquiry and a series of committees and a lot of dialogue.
08:50And that's currently being evaluated at the moment.
08:53In the state that I'm in, in New South Wales, we've just had a drug summit.
09:01But sadly, the premier, on the first day of the drug summit, said that he would not consider decriminalisation at all,
09:09and we weren't allowed to talk about it.
09:11So that was a way of shutting down public discussion and public dialogue, which was terrible for everybody.
09:19How do you have a conversation about decriminalisation, without shutting it down, but if you're still apprehensive?
09:28Let's talk about how to have that conversation with many people who maybe are, who have a knee-jerk reaction to that word.
09:35Sure, absolutely.
09:37So the first problem is most people don't share a definition of decriminalisation.
09:45So many people think it's legalisation.
09:48Which it's not.
09:49Which it's not.
09:49It is not.
09:50It is not making drugs supply legal.
09:54So that's the first thing.
09:56And in fact, these days, I don't use the term decriminalisation at all.
10:00I use the term removal of criminal penalties for drug use.
10:05Which is far more accurate.
10:07Which describes what it is, rather than giving it a label.
10:13And there are many ways in which you can remove the criminal penalties for drug use.
10:19But also by using that term, it becomes clear we're talking about drug use, not drug supply.
10:26Right.
10:27So from my point of view and the work that I do with governments, it's really important
10:33that police continue to have a role in managing drug supply and in arresting people who are
10:41supplying drugs and traffickers.
10:43That's a really important role.
10:45Right now they're spending all of their resources chasing people who are using drugs.
10:51If that was no longer a criminal activity, the police would not spend their time doing
10:57that and they would shift their resources to drug supply and drug cartels and trafficking
11:02because that's where all the violence and harm actually starts.
11:08Coming back to something you said a bit earlier about addressing fears.
11:11So part of our conversation about the removal of criminal penalties for drug use, part of
11:18that conversation has to do with addressing fears and the biggest fear you mentioned is
11:23that this will somehow jeopardise public safety, public security.
11:30Let's go deeper into that.
11:32Sure.
11:33Why is that the prevailing fear and how would you address that?
11:38Sure.
11:39Sure.
11:40Well, the first reason why people are fearful of that is because they believe that if you
11:45remove the criminal penalties for drug use, everyone will use drugs.
11:49So the only thing that stops people from using drugs is that it's a criminal act.
11:55Now, we know that that's not true.
11:57We know that people don't use drugs because they don't want to, because they want to look
12:04after their bodies, all sorts of reasons.
12:08So some people are afraid that public security will be damaged because as soon as you remove
12:15the criminal penalties for drug use, everyone will use drugs.
12:18Now, there aren't criminal penalties for alcohol use.
12:22Not everyone drinks alcohol.
12:24In fact, in here, a small proportion of the population drink alcohol.
12:30So criminal penalties don't stop people from doing things.
12:36So that's the first part of the fear.
12:38The second part of the fear, I think, is that there's not...
12:42Unfortunately, people don't meet people who use drugs very often.
12:49I mean, I'm lucky.
12:50I get to spend a lot of my time with people who use drugs.
12:53And they're just like you and me.
12:56They're not scary or difficult or angry or aggressive.
13:02They're us.
13:03They're humans.
13:04And I think people are afraid that somehow, I don't know, people who use drugs will become
13:11violent or aggressive or cause trouble in the streets and so on.
13:16And there's no evidence for that.
13:18I mean, if you look at Portugal, they removed the criminal penalties for drug use.
13:22They didn't have an uprising of public disorder.
13:27They didn't have an increase in drug use, which is the other kind of fear.
13:32So there's not evidence that removing criminal penalties would do that.
13:38And I think if we can get more people who use drugs to talk to the media, to talk about
13:44their drug use with their families, because they're very hidden right now.
13:48The other fear, if I may, and this is anecdotally just from me doing my job talking to people,
13:57has been the way people view people who use drugs.
14:03It's almost like a moral failing.
14:06So the removal of criminal penalties feels apprehensive about that because there's this
14:13element of punishment.
14:14We must punish them for this moral failing.
14:16How do you respond to that?
14:18So I think people have a right to have religious views and a view about what's moral and what's
14:28immoral.
14:29What we choose to call a drug is completely arbitrary.
14:36So let's take coffee.
14:38Coffee is a stimulant.
14:41Is it immoral to have coffee in the mornings?
14:44And does that, therefore, mean we should be punished?
14:49Nicotine is another drug that is commonly consumed.
14:54Nicotine is dependence forming.
14:55So is caffeine, the stimulant.
14:59What's the moral view about smoking?
15:03Nicotine is about vaping or about vaping or about the consumption of any form of nicotine.
15:09And then there are other drugs that we use to treat health conditions.
15:13There are opiates that we use when someone is in an enormous amount of pain or experiencing
15:20persistent chronic pain.
15:22Is that immoral that they are taking a heavy opioid, not dissimilar to heroin, to manage their
15:30pain?
15:31For some people, maybe that is immoral.
15:34But for most of us, that would be regarded as a sensible option to manage their pain.
15:41That's a wonderful way of putting it.
15:44I hadn't considered that before.
15:46You mentioned what we consider drugs.
15:49It's quite arbitrary.
15:50So that brought to my attention also.
15:54There's a rise of a whole generation of new and synthetic drugs, aren't there?
15:59Does that make the way we think about it, the current policy frameworks, the current research,
16:04does it make things more complicated with the rise of new synthetic drugs?
16:10No, it's exactly the same.
16:13But I think what's different is that we're used to the old drugs like heroin, cocaine,
16:19and then more recently, methamphetamines and crystal methamphetamine in particular.
16:26But the way in which policy could better manage this is exactly the same as spice, synthetic
16:35cannabis, or any of the new psychoactive substances that we're now seeing, which are basically
16:41chemical concoctions that are synthetic.
16:47So the supply chain is different.
16:49They come from factories.
16:51They come from chemists who are concocting chemicals to produce a certain effect, as opposed
16:57to coca farmers in South America, or as opposed to the herald poppy growing.
17:04So the source of the supply is different.
17:06But actually, our policy response should be the same.
17:10Reduce supply, engage in law enforcement around trafficking, provide treatment, provide support,
17:19provide education, and harm reduction.
17:21So when you say the removal of criminal penalties for drug use, it would be then replaced with
17:27treatment and education.
17:30Talk to me about what comes in to fill in that gap.
17:33So there are two debates, two options here that countries face.
17:37The first is to say, we're going to remove the criminal penalties for drug use, and we're
17:42going to replace it with treatment.
17:44That's option one.
17:46And in a sense, Portugal has done that with the commissions of dissuasion.
17:51The second option is to say, let's remove the criminal penalties for drug use, and not do anything.
18:00And many countries have done that, because not everybody who uses drugs needs treatment.
18:09So a lot of people use drugs recreationally, occasionally, in non-dependent forming ways,
18:18in the same way as many people drink alcohol, socially, but then some people do run into trouble.
18:26No question, there are people who run into trouble with alcohol, there are people who run into trouble
18:30with drugs, they need treatment.
18:31But to put everybody into treatment, it's expensive, and it's not a good use of resources.
18:40Okay, so help me think through the good policy design, the trade-offs, based on what we know.
18:47There are trade-offs, yeah.
18:48So it all depends on the context and the society that you're in.
18:55So what would work really well here is not the same as what would work in Portugal, or Australia,
19:01or Ireland, or anywhere else.
19:04If you've got a really good healthcare system that already has a workforce that can work with
19:11people who use drugs, you probably need to put less into the treatment side of things, because people...
19:19Imagine a world where there were no criminal penalties for drug use, and you could talk about it,
19:25and you had a friend who was having a bit of trouble over the weekend.
19:30You would help them and take them to the local healthcare centre, and say,
19:33I think my friend needs to talk to someone, we've had a bit of trouble over the weekend.
19:38And that would be perfectly fine, an appointment would be arranged, they would get education,
19:43information, and it would all be...
19:45Find an end.
19:47Be find an end, that's right.
19:49But that means you've already got a good health system,
19:51with a workforce of doctors, nurses, social workers, who aren't, don't discriminate.
20:01Right, who have the capacity to deal with...
20:04And don't stigmatise someone who comes in.
20:07I understand.
20:08In places where you don't have that, and maybe that's not the case yet here in Malaysia,
20:14you might want to make sure everyone got treatment and set up special treatment services,
20:19community-based, to make sure that everyone had a conversation with someone about their drug use.
20:27Okay, so it really depends on the context.
20:31When you mentioned some countries did this and some countries did that,
20:35so Portugal was one example that you said provided treatment.
20:39Which of the other countries that decided not to,
20:42and what were the trade-offs for not providing treatment?
20:45Yeah, so Czech Republic is an example of a country,
20:48and there's a few other Eastern European countries that have done this.
20:56I guess the trade-off is that there will be people who will slip through the net
21:02and won't get the help that they need and may continue on with their drug dependence
21:08and experience a lot of harm associated with that.
21:11So really the question is, what are you valuing the most?
21:17Are you valuing ensuring that everybody gets a health response?
21:22Or are you letting other parts of society, family, communities kind of pick up where the policing stops?
21:32Okay. When you think about sound policy design around drug policy, I mean, I'm essentially asking you.
21:41Well, it's all context dependent.
21:43Correct.
21:44So I can give you an example.
21:45Are there penance?
21:46I mean, I'm working in one of our states in Australia, Victoria at the moment,
21:50and we've just designed a policy for the removal of criminal penalties,
21:54and we've got no action in that policy. So in that place, we're not choosing
22:02a mandatory referral to education or counselling or treatment.
22:06Okay.
22:07We're saying nothing happens.
22:09So the onus is then back on the person who uses drugs to get help if they need it?
22:16It's not an onus. It's a choice.
22:20Sorry, apologies. A choice. Okay. Which brings me to my next question.
22:25People, the public, the media, policymakers, we have to undo and unlearn decades of indoctrination
22:33around the war on drugs. What would you say to our audience at home as well, to me myself,
22:39as I'm learning as part of this journey? How do we shift our mindset away from the punitive thinking,
22:46from the thinking about the war on drugs, that mindset that we have? What's the message,
22:53if we want to move away from that narrative?
23:00I wish I had the best sound bite for you. I don't know that I do. I mean,
23:06there's sort of two bits to it, I guess. The first is that everyone who uses drugs does not
23:12become dependent and experience problems. So remembering that. And secondly, the people that do
23:22become addicted or dependent on drugs need help and need compassion. And we know that there are
23:29really good treatments, treatments that work. And like with any other health condition, why would you
23:36deprive someone of effective treatment? Professor Reto, thank you so much for being on the show with me,
23:42helping me think through some of these really nuanced discussions about drug policy. I appreciate
23:48your time. My pleasure. Thank you for having me. That's all the time we have for you on this
23:52episode of Consider This. I'm Melissa Idris, signing off for the evening. Thank you so much for watching,
23:57and good night.
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