OPINION: Australia21, of which I am one of the directors, released its second report on drug prohibition this morning. The report calls for a redefinition of how we deal with drugs to primarily a health and social problem.

Our first drug report, released in April, concluded that the war-on-drugs approach had failed comprehensively. It provoked a vigorous media response in which few commentators challenged the notion that heavy reliance on drug law enforcement had failed.

We invited prominent Australians who support a hardline approach to attend a meeting but all those approached declined. When someone of the stature of Mick Palmer, former commissioner of the Australian Federal Police, acknowledges that despite improvements in drug law enforcement, there has been little impact on the drug market, the debate has entered a new stage.

This second report builds on the conclusions of the first one, attempting to provoke a national discussion about what our best options might be. There are several reasons why this discussion is now different from previous debates about drug policy.

Winds of change in the Americas

Vigorous debates about drug policy are now taking place in Europe and the Americas. The murder of 50,000 Mexicans since President Felipe Calderon declared a war on drugs in December 2006 has brought that country to a precipice. Two previous Mexican presidents have called for legalisation and the current one has called for use of “market mechanisms” – presumably a euphemism for legalisation.

Latin America is being torn apart by pressure from the United States to stop drugs heading north to the biggest drug market in the world. President Barack Obama was forced to bow to pressure from Latin America in April and acknowledge (in an election year) that it was entirely appropriate to debate the legalisation of drugs, although he added this was something the United States would never do.

In a world-first, Uruguay’s president has sent a Bill to legalise cannabis to the legislature for consideration. At the Summit of the Americas in Cartegena, Colombia, earlier this year (14 to 15 April), the United States and Canada were isolated on drug policy. Latin America now wants change.

The politics of drugs also seems to be changing in the United States. Primaries for a Democratic Congressional district in El Paso, Texas and a contest for the Oregon attorney general were both won by younger candidates supporting drug law reform, defeating older incumbents who supported a war-on-drugs approach.

And, the 2011 annual Gallup poll in the United States, asking “do you support the legalisation of marijuana?” reported that supporters (50%) now outnumbered opponents (46%). In 1969, 12% supported while 84% opposed legalisation of marijuana. Medical marijuana is now available in 17 states (and the District of Colombia).

The situation in Europe

There are now more countries providing models for how reform can be implemented. The Netherlands, Switzerland and Portugal have shown that reforms can be carried out without breaching international drug treaties, and that an approach with more emphasis on health and social measures can produce better outcomes and achieve strong community support.

In contrast, Sweden is one of few European countries still heavily reliant on severe punishment and drug law enforcement. It claims a drug-free nation as the over-arching goal of its drug policy and rejects safer injecting facilities and heroin assisted treatment.

Sweden still only has the same two needle syringe programs that were established 25 years ago. And it has the eighth-highest drug overdose death rate in the European Union while the Netherlands has the 19th and Portugal the 25th. Overdose deaths have been increasing in Sweden, are stable in the Netherlands and falling in Portugal.

Still, the country seems to be slowly moving away from its hardline approach and gradually becoming more like other European Union countries. And it takes drug treatment seriously, as do all countries that have started reforming their drug policy.

Coinciding with a major expansion and improvement of drug treatment in Zurich, Switzerland, the estimated number of new heroin users declined from 850 in 1990 to 150 in 2002 with decreasing numbers of heroin overdose death, HIV infections and crime. The quantity of heroin seized by police also declined during this period suggesting a shift from the black market to the white market.

Time to make the move

Sooner or later, one side of politics in Australia will realise that drug law reform could be a vote-changing issue for young people. With the current and two previous presidents of the United States, and the current prime minister of Australia, and the current and previous leaders of the Opposition all known to have tried cannabis, it’s increasingly difficult to explain why two to three million Australians are better off purchasing cannabis from criminals, corrupt police or outlaw motorcycle gangs than obtaining the same drug from regulated sources.

Drug policy is a difficult issue for politicians. But the longer they delay reform, or even discussion of reform, the more difficult it’s going to get.

Dr Alex Wodak is Director, Alcohol and Drug Service at St Vincent's Hospital in Sydney. He is a Conjoint Senior Lecturer at UNSW and a member of UNSW's Australian Drug Law Reform Initiative.

This opinion piece first appeared in The Conversation.