Global health. The current scenario and future perspectives

222 Likely it is here where we will find the great challenge in public drug policies (as well as in many other fields) soon: generate bridges that bring science and politics closer. Both are necessary, but they themselves are not sufficient for generating policies that address phenomena from their causes rather than focusing efforts solely on dealing with consequences. As mentioned before, these causes have different dimensions and work must be done on each one of them. And it is in this aspect where the public health approach plays a fundamental role. We have seen with great concern that drug policies have been focused on “interventions” without a clear diagnosis for proper guidance of these policies or actions, and without a process of monitoring and evaluation. Clear diagnoses and evaluations have been absent in decisions that have been made on drug policies. It has been much more relevant to provide quick responses in the field of security rather than investigating the causes for drug use and, therefore, the demand for them. In the foreword of the 2012 report by the International Narcotics Control Board (INCB) (INCB, 2013), part of United Nations, an interesting reflection is made in this direction. It states: “To target the organized crime and violence associated with the illicit trade in drugs, the most effective tool is primary prevention of drug abuse, coupled with treatment and rehabilitation, and complemented by supply reduction measures, as provided for in the conventions.”. One may fully or partially agree with this proposal, but what is interesting about it is that it suggests that the “war on drugs” does not take place where supply occurs, but rather focuses on reducing substance demand. If this understanding does not exist in policymaking, then problems will only increase in the future: greater diversity of substances and more people using them. In addition to this discussion, there is also a need to consider (and decide in some cases) expanding new regulatory frameworks for cannabis for recreational purposes from production to distribution and consumption across territories. A critical analysis of the impacts of these new policies in countries or geographic areas where they have been implemented is necessary. However, the same analysis must be conducted in places where the current prohibition regime is maintained. Once again, generating scientific evidence is crucial, as well as using it without bias. This discussion is still pending. Regardless, the future will also be dominated by the crossroads posed by both new psychoactive substances and indiscriminate use of analgesics (particularly fentanyl), which, as mentioned before, account for an unexpected number of deaths from overdose in the northern hemisphere. The rest of the countries are not exempt from facing similar situations in the future.