Medical professionals, including doctors, nurses, pharmacists, and others, occupy a position of respect within the United States. Entrusted with the care of individuals and the protection of public health, we carry the weight of lives in our hands. This awareness of the profound trust vested in us impels medical organizations to consistently advocate for government policies that foster public health excellence.

Sadly, many physicians continue to support the War on Drugs, even as it has proven to be a failure by almost every measure. The sobering reality of more than 100,000 annual deaths due to drug overdoses within the U.S. serves as an unequivocal testament to the inefficacy of our punitive approach toward drug use. And the War on Drugs has led to our current crisis of mass incarceration, which has led to a far greater percentage of imprisoned individuals than any other democracy in the world.

The Problem

For nearly a century, society has adopted a punitive stance towards drug use. This approach has incurred substantial social and economic tolls, leading to the militarization of local law enforcement, congestion of penitentiaries with non-violent offenders, disproportionate targeting of individuals from marginalized communities, escalation of violence and organized crime, hindrance of potentially valuable research, prioritization of punishment over rehabilitation, erosion of public confidence in our institutions, and obstruction of our capacity to effectively regulate substances. Regrettably, despite these profound repercussions, this approach has shown minimal, if any, success in diminishing drug consumption.

To quote Dr. Nora Volkow, the Director of the National Institute of Drugs at the U.S. National Institutes of Health:

"We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance. Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized. Drug use continues to be penalized, despite the fact that punishment does not ameliorate substance use disorders or related problems…These [racial] disparities are particularly stark in the field of substance use and substance use disorders, where entrenched punitive approaches have exacerbated stigma and made it hard to implement appropriate medical care. Abundant data show that Black people and other communities of color have been disproportionately harmed by decades of addressing drug use as a crime rather than as a matter of public health…Five years ago, the 193 member nations of the United Nations General Assembly Special Session on drugs unanimously voted to recognize the need to approach substance use disorders as public health issues rather than punishing them as criminal offenses."

A Voice for Physicians

Since the 1990s, Dr. David Nathan, a highly respected psychiatrist and medical educator based in New Jersey, observed the growing support for cannabis legalization among his fellow clinicians. However, these viewpoints remained stifled within the broader medical community. Frustrated by this incongruity, Dr. Nathan took to the pages of the Wall Street Journal to voice his perspective in an op-ed titled, "A Doctor’s Case For Legal Pot." The overwhelming positive response to his stance emboldened him. In 2015, Dr. Nathan rallied fifty prominent physicians from across the United States to bridge the gap between the ineffective policy of prohibition and the unregulated legalization of cannabis.

This collaborative effort gave birth to Doctors for Cannabis Regulation (DFCR), the premier national physicians' association committed to the legalization and responsible regulation of cannabis in the United States and abroad. Today, DFCR has emerged as a global advocate, representing the voices of over 400 physicians and licensed medical practitioners, in support of evidence-based cannabis regulation and legalization. We have provided expert testimony in significant legislative contexts, including the first-ever Congressional subcommittee hearing on cannabis legalization and on dozens state-level initiatives and bills pertaining to medical and adult-use cannabis. DFCR has collaborated with other advocacy groups to educate the public through webinars on subjects such as Women’s Health and Cannabis, Biden’s executive pardon and call for rescheduling, and Brittany Griner’s imprisonment.

DFCR is principally responsible for the creation of a universal symbol to be displayed on all cannabis product packages (and adopted by four states) and a white paper addressing cannabis use within healthcare settings. And we have aligned ourselves with international bodies, such as the Vienna NGO Committee Commission, and with national coalitions like the Drug Policy Alliance’s Marijuana Justice Coalition, alongside numerous state-level organizations, to collectively advance cannabis regulation and legalization. Our Experts include many of the leading academicians and clinicians in the cannabis field. In short, DFCR has elevated the physician's voice, fostering informed dialogue and advocating for sensible cannabis regulation at the heart of global and national conversations.

In the years since our launch, the legalization of cannabis has become a success story. A broad majority of Americans now support the legalization and regulation of cannabis for both adult and medical use. Legal medical cannabis is now available to more than 75% of the U.S. population and adult use cannabis is legal to almost 50%. This support crosses party lines, which is a rare example of bipartisanship in public policy. Multiple other countries have also legalized cannabis for either adult use (8 countries) or medical use (51 countries).

A great deal more needs to be done to expand legal cannabis access, achieve comprehensive national regulation (both in the U.S. and globally), and refine and standardize regulatory control to maximize public health. Nonetheless, the ongoing failure of the global drug war – coupled with the worsening overdose crisis – compels us to broaden our mission.

Moving Ahead

Since its inception, DFCR’s core mission has centered on enhancing public health through the evidence-based regulation of cannabis and dismantling punitive measures associated with its use by adults. Our aspiration has always been to extend these endeavors to encompass all currently banned substances. While numerous other entities have taken the lead in confronting the inequities and harms of the war on drugs, the perspectives of medical professionals have frequently been overlooked. In a conscious effort to amplify the voices of physicians and other duly licensed medical experts, our organization now embarks on a broader commitment to address the global war on drugs.

Why involve physicians and other medical professionals? Health experts possess a deep understanding of the repercussions of drug use. They study the impact of criminalization of drugs on public health, which can yield a more holistic approach. Health professionals can critically evaluate empirical data and steer clear of the inclination to punish health-compromising behaviors. Nonetheless, many medical practitioners have become entangled in the War on Drugs across various domains, including child welfare, drug treatment, drug testing, and access to care. These unintended roles have often cast us as unwitting enforcers of the drug war.

And the medical community has been stunning strides in dramatically lessening drug harms through prevention, education, and taxation. A compelling illustration lies in the past 50-year period during which cigarette consumption decreased from 51% to 17% among adults, emblematic of a significant public health triumph achieved without resorting to prohibitionist policies. By channeling their efforts effectively, medical professionals possess the potential to effectuate positive change – without resorting to laws that arrest, incarcerate, and disenfranchise.

Addressing Institutional Resistance

Unfortunately, even inadvertently, medical practitioners have become entangled in the war on drugs across various domains such as child welfare, drug treatment, drug testing, and the healthcare system. These unintended roles have cast us as unwitting enforcers of the drug war.

Our medical associations have been particularly resistant to addressing the harms of the War on Drugs. Although the AMA spoke out strongly against the 1937 U.S. Marijuana Tax Act almost a century ago, very few medical organizations have supported cannabis legalization for medical or adult use. Many have argued against cannabis legalization and regulation, while others have remained silent. And few of these organizations have acknowledged the injustice of drug prohibition and its horrific economic, social, and public health consequences – both in the U.S. and globally. As our younger physicians find their voice and push for change, we believe our professional organizations will follow. D4DPR aims to encourage, energize, and focus these voices and effect change from within.

We have also been motivated by the ground-breaking work of International Doctors for Healthier Drug Policies (“IDHDP”).  Founded by Dr Chris Ford in 2009, and under the guidance of Sebastian Saville since 2013, IDHDP became the voice of medical doctors and clinical practice in the world of drug policy. A global network of over 1000 physicians from more than 100 countries, IDHDP has provided a reasoned yet passionate voice to doctors challenging ill-conceived policies throughout the world. With the recent closing of IDHDP, we hope to follow in the path that they paved before us.

Our Expanded Mission

To reflect this expansion of our mission, on Oct 2, 2023 we will change our name to Doctors for Drug Policy Reform (D4DPR).  There are many reasons for this rebranding:

• Broader Scope: "Doctors for Drug Policy Reform" implies a broader approach to addressing drug-related issues, going beyond just cannabis. This expansion allows our organization to address a wider range of drug policy issues.
• Reducing Stigma: By rebranding, the organization aims to destigmatize discussions about drug policy reform as a whole and advocate for evidence-based approaches to all substances.
• Inclusivity: A broader focus on drug policy reform allows us to include more health professionals and experts who may have concerns about various drugs' effects on public health or potential benefits for health and wellness, rather than being solely centered on cannabis.
• Policy Impact: Expanding our organization's mandate to include all drugs allows it to engage in advocacy and policy reform efforts that have a more comprehensive impact on public health and drug regulation. 
• Plant Medicine:  Both cannabis and psychedelics offer unique, life-saving potential for a wide variety of mental health and medical disorders. Expanding our mission to include psychedelics for both health and wellness allows us to address issues of health access, federal research support, decriminalization, and state-regulated access.
• Public Perception: The rebranding will allow our organization to be viewed as a more credible and balanced advocate for drug policy reform, as it demonstrates a commitment to addressing the broader range of drug-related issues rather than focusing solely on a single substance.
• Collaboration Opportunities: By adopting a more inclusive name, the organization may find it easier to collaborate with other groups and stakeholders in the drug policy reform arena, including those advocating for the reform of policies related to substances other than cannabis.‍
• Educational Outreach: The broader scope of "Doctors for Drug Policy Reform" allows the organization to educate doctors, other health professionals, scientists, policy makers, and the public about the complex issues surrounding drug use, addiction, and regulation, fostering a more informed and evidence-based approach to drug policies.

 D4DPR will be guided by the following Organizing Principles:

• Advocate for drug policies that are grounded in empirical evidence, public health, racial justice, equity, and human rights.
• Promote science-based policies that recognize individual agency, respect bodily autonomy, and assure that people who use drugs are supported instead of punished.
• Advocate ongoing research and review of drug policies to verify their effectiveness, adapting policies as new evidence emerges.
• Promote practices for individuals experiencing drug use problems that are evidence-based, minimize harm, and provide the resources necessary to maintain health and safety. 
• Promote education and prevention efforts to ensure that our patients and the public are provided unbiased information regarding the potential benefits and harms of all drugs, including prevention education for minors.
• Engage in international collaboration to change global drug-related policies.
• Repair the harm to public health caused by the War on Drugs.
• Recognize the importance of Indigenous knowledge holders and the preservation of ancestral wisdom regarding plant medicine.

D4DPR Platform

Our Platform includes four overlapping categories. Maximizing Health and Wellness emphasizes the importance of an open-minded approach to treatment as well as the psychiatric and somatic benefits offered by presently prohibited medications. Harm Reduction provides clear and concise policy statements that will guide our approach to drug use and misuse. Cannabis continues our ongoing work on cannabis regulation and legalization. Psychedelics acknowledges the explosion of clinical research in psychedelic medicine. 

Maximizing Health and Wellness

• Access to health promoting interventions and treatment, both abstinence and non-abstinence based, to individuals with drug use problems
• Recognition of the potential health benefits of promising Schedule I drugs, including cannabis and psychedelics
• Federal protection of licensed medical professionals providing evidence-based treatment with Schedule I drugs consistent with state laws, including the discussion of their benefits and risks

Harm Reduction

• Empirically-supported harm reduction efforts (“meeting people where they are”) to promote public safety, protecting individuals using drugs and society
• Protection of the public through overdose prevention centers, syringe services, naloxone distribution, drug-checking, treatment (including opioid agonist therapies), Good Samaritan laws, and other evidenced-based interventions
• Reduction/removal of penalties for drug possession and use

Cannabis

• Government regulation of cannabis production, testing, labeling, distribution, and sales
• Prevention of non-medical underage cannabis use
• Cannabis competency for all medical providers
• Protected rights for limited home cultivation of cannabis
• Reduce public health risks associated with overcommercialization

Psychedelics

• Access to psychedelic medicine for all individuals who can benefit, regardless of socioeconomic status
• Protection of licensed medical professionals utilizing their scope of practice when conducting psychedelic-assisted therapy and care
• Healthcare coverage parity for psychedelic medicine

Our board feels passionate about our new path as we embark on this broader trajectory for our organization. We anticipate a comprehensive engagement that will confront the injustices, damages, and the rising toll of fatalities resulting from drug prohibition. We invite you to join us in our endeavor to foster a more empathetic, empirically-based, and deliberate approach to the complexities of drug use and misuse.

“…the so-called war on drugs approach…perpetuates existing patterns of discrimination, including individuals of African descent, women, and Indigenous people.  Driving the drug trade underground leads to the development of criminal networks. It is clear to many that the so-called War on Drugs is not working and a number of countries have led the way forward.

We must continue this progress in all regions of the world order and stop this so-called War on Drugs. Instead, let us focus on transformative change, crafting drug policy based on evidence which puts human rights at the center…and ultimately will improve the lives for the millions of individuals effected.” —Victor Türk, UN High Commissioner for Human Rights. March 13, 2023

Download the Original DFCR Declaration of Principles (2015) and our 50 Founding Members.