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Based on observations around the US opioid crisis and cannabis legalisation in Uruguay, Kasia Malinowska-Sempruch and Diederik Lohman made a call to the public health community to challenge drug prohibition.1 It remains unspecified whether the call suggests legalising all drugs internationally or refers to advocating for evidence-based drug policy. The US opioid epidemic, related to legal prescription drugs in a specific geopolitical context, has health outcomes which differ from those of cannabis or other drugs.2 There are forms of regulation that do not seem to contradict market prohibitions.2 Decriminalisation and opioid substitution therapies can be successfully implemented, while the trade of heroin remains illegal.3 The reference to successful tobacco regulation is appealing because the trend goes from fewer to more regulations and prohibitions, first in specific places and populations (eg, in prisons) and then to entire birth cohorts and generations (eg, in Denmark and New Zealand).4

d, while the trade of heroin remains illegal.3 The reference to successful tobacco regulation is appealing because the trend goes from fewer to more regulations and prohibitions, first in specific places and populations (eg, in prisons) and then to entire birth cohorts and generations (eg, in Denmark and New Zealand).4 Further inferences warrant a closer look: challenging drug prohibition might not resolve police harassment, which should be firmly sanctioned globally. Interactions between the police and people with substance use problems might further occur due to different types of offences, including in countries with liberal drug regulations.5 Many countries in Europe and Latin America dropped the prosecution of possessing small amounts of cannabis and growing plants at home, maintaining market prohibition.3 And, to our knowledge, there is not sufficient evidence supporting that countries should further legalise cannabis or other drugs. The different levels of evidence, classes of drugs, and geopolitical regions3 restrict global calls on this topic.