The wars on drugs worldwide have failed and doctors should lead calls for change, says The BMJ, a weekly peer-reviewed medical journal and one of the world's oldest general medical journals.

The enforcement of prohibition -- a ban on the production, supply, possession and use of some drugs for non-medical purposes -- causes huge harm and doctors should lead calls for drug policy reform, argues The BMJ.

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Prohibition laws, colloquially known as the "War on Drugs," cost at least $100 billion annually but have failed to curb either supply or demand, reduce addiction; minimize harm; reduce violence and limit profits for organized crime, argue The BMJ editor-in-chief, Dr. Fiona Godlee and features and debates editor, Richard Hurley.

Far from diminishing over time, drug use has grown substantially worldwide and continues to exact a tragic toll on individuals and societies.

In 2014, a quarter of a billion adults -- one in 20 worldwide -- may have taken an illegal drug such as cannabis, cocaine or heroin. A quarter of 15 year-olds in the United Kingdom might have taken illegal preparations of unknown quality and potency.

Calls for reform come as no surprise, and at a UN General Assembly last April, many countries asked for health and human right to be prioritized over punitive responses.

Some countries have already removed criminal penalties for personal drug possession, said Dr. Godlee and Hurley. For instance, Portugal replaced criminal sanctions for drug use with civil penalties and health interventions 15 years ago.

The UK's new Psychoactive Substances Act criminalizes the supply but not use of synthetic drugs, while some U.S. states like California have legal cannabis markets. The Netherlands has tolerated regulated cannabis sales for decades.

A recent international evidence review concluded governments should decriminalize minor drug offenses; strengthen health and social sector alternatives to criminal sanctions; move cautiously towards regulated drug markets and scientifically evaluate the outcomes to build pragmatic and rational policy.

"Health should be at the center of this debate, and so, therefore, should healthcare professionals," they write.

"Change is coming, and doctors should use their authority to lead calls for pragmatic reform informed by science and ethics."

Ruth Dreifuss, former President of Switzerland and chair of the Global Commission on Drug Policy, says the need for more effective and humane drug policies is now more urgent than ever.

She argues for a pragmatic approach to drug policy reform, starting with the recognition that the idealized notion of a "society without drugs" is an unattainable fantasy.

Reforms must prioritize issues of public health, social integration and security, while strictly respecting human rights and due judicial process, she writes.

Decriminalization can and must go further, she adds. In its upcoming report, the Global Commission calls for governments to regulate all illicit drugs. This would curb a massive revenue stream for organized crime, worth an estimated $320 billion.

Tagswar on drugs, Drug addiction, prohibition, The BMJ, UN General Assembly, Decriminalization