Is the "war on drugs" an effective policy to manage a problem or does it do more harm than good?

For context, this is a question I answered on Quora

Without the war on drugs we would not have been deprived of the benefits psychedelics have to offer to alleviate ever more prevalent psychological disorders. Putting them on schedule 1 of the CSA was a setback for science and medicine and it is only recently that the error of the drug war mind set has become apparent to most rational thinking people. Even though they remain illicit on the federal level we already have preliminary evidence from numerous small experimental and naturalistic studies that psychedelics can alleviate symptoms of depression, anxiety, bipolar disorder, ADHD and even PTSD with micro-doses.

Psilocybin

An open label single arm clinical trial conducted among patients with treatment resistant major depression (n =12) found that two doses of psilocybin (10 mg and 25 mg) given one week apart significantly reduced baseline Quick Inventory of Depressive Symptoms and State-Trait Anxiety Inventory scores up to 3 months in post treatment follow up for 7/12 patients with peak effects occurring 2 weeks post treatment. All patients showed reduced depression and anxiety severity one week after treatment

Another open label single arm trial conducted among patients with bipolar 2 depression over 12 weeks (n = 15), found that a single 25 mg dose of synthetic Psilocybin administered in a controlled therapeutic environment found that 12/15 participants met the response criteria for a 50% reduction in their Montgomery-Åsberg Depression Rating scale score while 11/15 participants experienced complete remission of symptoms 3 weeks after dosing. 12/15 participants experienced complete remission 12 weeks after dosing.

A prospective survey study conducted online among participants with self-reported ADHD diagnosis by a psychiatrist or self-reported symptoms without a diagnosis, who completed the Conners’ Adult ADHD Rating Scale at baseline to determine inclusion in the study, that also have prior experience microdosing psychedelics (n = 233) found that participants were more mindful 2 weeks after microdosing and scored higher on traits of openness and agreeableness 2 to 4 weeks after microdosing while simultaneously scoring lower on traits of neuroticism. Most participants who microdosed psychedelics took psilocybin containing mushrooms and truffles with a mean dose of 722 mg.

Another online survey study (n = 3,590) found that respondents who used psychedelic microdosing to self-medicate a diagnosed psychological disorder rated it significantly more effective than conventional therapy and prescribed treatment for ADHD, ADD and anxiety disorders. The most common psychedelic was psilocybin followed by LSD.

DMT

A double blind placebo controlled RCT conducted among adults with treatment resistant major depression recruited through outpatient psychiatric referrals in Brazil (n = 29) found that patients who were given a single 1 mL/kg dose of ayahuasca containing an average of 360 micrograms DMT and 1.86 mg harmine, 240 micrograms harmaline, and 1.2 mg tetrahydroharmine had lower Hamilton Depression Rating scale one week after baseline measurements were taken compared to patients given an inactive placebo despite the former having higher baseline scores. Statistically significant between group differences in Montgomery–Åsberg Depression Rating Scale scores were found after only a day with the ayahuasca group having much larger decreases from their baseline scores indicating a rapid antidepressant effect.

A survey study conducted within a group who uses 5-MeO-DMT in a controlled setting with stipulated doses, guidelines for preparation and mutual support during/following DMT sessions found that respondents who participated in at least one session between 2007-17 and completed the survey (n = 362) and had depression (n = 149), anxiety (n = 173), or both (n = 117) experienced improvements in their symptoms after their DMT session. 80% of respondents with depression experienced improvements in their condition following their DMT session compared to only 3% who reported worse depression symptoms. 79% of respondents with pre-existing anxiety reported reduced anxiety following their DMT session compared to only 2% who reported worse anxiety. Only 7 respondents went into their DMT session with the intention of alleviating their depression and/or anxiety. The authors found ‘no differences in the intensity of acute challenging experiences between those who did or did not report an improvement in depression or anxiety’ indicating these effects occurred independent of both differences in expectations and past trauma.

LSD

A phase 2 double blind placebo controlled RCT conducted among adults with life threatening disease associated anxiety recruited through hospital presentations and cancer support groups in Switzerland (n = 12) found that two 8 hour experimental sessions with LSD done 3 weeks apart followed by 3 physiotherapy sessions reduced State-Trait Anxiety Inventory scores for participants given 200 microgram doses including below the diagnostic cut-off for generalized anxiety disorder for 3 of the 8 participants given that dosage at the 2 and 12 month follow ups. The 20 microgram active placebo dose increased State-Trait Anxiety Inventory scores at the follow up periods.

Last year, the FDA gave breakthrough therapy status to an LSD treatment for general anxiety disorder based on results from a phase II clinical trial which showed a single dose of LSD sustained a 48% clinical remission rate of GAD for 12 weeks. If LSD had never been added to schedule 1 of the Controlled Substance Act over half a century ago we probably would have realized it’s benefits sooner.

MDMA

A double blind placebo placebo controlled RCT conducted among adults with treatment resistant PTSD recruited through their psychotherapists (n = 20) found that a combination of psychotherapy and a 125 mg dose of MDMA with an optional 62.5 mg offered 2.5 hours afterwards improved PTSD symptoms assessed through the Clinician-Administered PTSD Scale more than the placebo at the follow up periods. 83% of MDMA patients experienced a greater than 30% reduction in PTSD symptom severity, as measured through the Clinician-Administered PTSD Scale, and no longer met DSM criteria for the disorder compared to only 25% of patients who received the placebo after the first stage of the experiment. In the unblined placebo crossover stage, seven former placebo subjects experienced a greater than 30% reduction in PTSD symptom severity with three being able to return to work after previously being unable to work. Overall, MDMA had a larger between group effect size over placebo controls than the SSRIs typically used in PTSD treatment at the 2 month follow up.

A phase 2 double blind RCT conducted among veterans and first responders diagnosed with PTSD for 6 months or more at an outpatient psychiatric clinic (n = 26) found that titrating from 30 mg to 75 mg of MDMA produced the largest between group effect size difference in PTSD symptom severity reduction as measured through the Clinician-Administered PTSD Scale.

The war on drugs also spawned extra-judicial police tactics that deprive innocent people of fundamental 4th and 5th amendment rights: something I documented 8 years ago.

Civil Asset Forfeiture, Anti-Structuring Laws and Other Spawns of The War on Drugs