After almost 100 years of international drug control agreements, that have pursued prohibitions on the production, distribution and use of some psychoactive substances, questions about the efficacy, and even the validity, of these strategies are growing louder. It seems clear that the objective of a ‘drug free world’ - or at least a significantly reduced illegal market in plant based drugs such as cocaine, heroin and cannabis, and synthetically produced drugs such as ecstasy, amphetamines, and LSD – is as far away as ever.

This paper examines why the vision of the architects of the global prohibition regime has not been achieved, but also goes on to describe the damage to human health and welfare that has arisen from badly conceived and implemented drug control policies and programmes. The author goes on to analyse the political and institutional barriers to objective review and modernisation of drug policies at national government level, and at the United Nations. Finally, the concluding section lays out the broad options that policy makers face for a future ‘direction of travel’.