When Ghana's Narcotics Control Commission Act (Act 1019) was passed in 2020, it was celebrated as a landmark piece of legislation. It promised a revolution in drug policy—a shift from the handcuffs of the past to the healing hands of public health. Yet, approaching six years later, a fundamental paradox lies at its core. While the law speaks the language of rehabilitation, its heart still beats with the pulse of prohibition.
The Act’s stated goals are progressive: to establish a dedicated rehabilitation fund and prioritize treatment and harm reduction over pure enforcement for low-level drug offences. But by attempting to be both a healer and a jailer, Act 1019 has created a legal paradox that traps the very people it claims to rescue. The Act's punitive core remains firmly in place, creating a framework that is fundamentally at odds with its own health-focused mission.
The preliminary findings of the 2025 Integrated Bio-Behavioral Survey (IBBS) provide stark evidence that "draconian" practices persist and are costing lives. It is a law in conflict with itself, and the most vulnerable are paying the price. As the distinguished drug policy scholar Dr. Joanne Csete observed, "Plainly, there is a chasm into which policies fall on the way from the rhetoric to the reality”.
Four Surprising Realities of Ghana's Drug Law Reform:
1) A 'Public Health' Law That Criminalizes Patients
The fundamental contradiction within Act 1019 is that it attempts to walk in two opposite directions at once. The law mandates a public health approach while simultaneously criminalizing the health condition it is supposed to treat. According to section 3(i) of the Act requires the Narcotics Control Commission to "ensure that substance use disorders are treated as a public health issue. However, section Sections 41, and 45 of the same Act explicitly criminalize the personal possession and purchase of drugs.
This internal conflict forces the law to prosecute the exact individuals it seeks to help. Instead of establishing a "user-as-patient" paradigm, it reinforces the old "user-as-criminal" model, actively deterring people from seeking the very services the law supposedly supports.
2. The Human Cost of Flawed Legislation: Evidence from the Front Lines
The legal paradoxes of Act 1019 are not theoretical. They have failed to address a public health crisis with devastating real-world consequences, as revealed by data from the front lines. The 2025 IBBS, conducted by the University of Ghana School of Public Health, paints a stark picture of a health emergency among people who use drugs:
• HIV Prevalence: HIV rates among people who inject drugs have skyrocketed to 12.5%, compared to just 2% in the general population.
• Hepatitis C prevalence among people who inject drugs in certain regions is an alarming 12.7%.
• It is estimated that over 45% of people who use and inject drugs are battling moderate to severe depression.
These statistics are a direct consequence of fear. Nearly 50% of surveyed individuals reported being harassed or arrested by uniformed officers in the last six months. This constant threat drives people underground, away from sterile needles, HIV testing and other life-saving services. The result is a hidden epidemic: it is also estimated that only 27.7% of HIV-positive people who use drugs are aware of their status. We cannot treat what we cannot find.
3) When Legal Ambiguity Becomes a 10-Year Sentence
A critical failure of Act 1019 is its refusal to define clear, quantified thresholds that distinguish personal use from trafficking. The law’s definition is dangerously vague, stating that possession for personal use is a quantity that does not exceed what "can reasonably be used by an individual in a day" (Section 113).
This ambiguity grants arresting officers’ immense discretion to decide whether an individual is a patient or a felon facing a mandatory minimum 10-year prison sentence. This creates fertile ground for inequity and corruption, as police can reportedly charge individuals with the more serious offense of supply if they refuse to pay a solicited bribe.
The devastating result of this legal grey area is not theoretical. During a focus group discussion in a study conducted in 2023, one judge recounted being forced by the law to sentence a young woman to 10 years in prison. Her crime was sending a small amount of a drug to her boyfriend hidden inside a meal of waakye. What was a simple act of personal connection was twisted by a poorly written law into a life-changing prison sentence.
4) The 'Alternative' to Jail Is a Fine Too High to Pay
Act 1019 was praised for introducing non-custodial sentences, but the exorbitant fines render this alternative an illusion for most. However, the fine for possession for personal use is between GHS 2,400 and GHS 6,000. These figures are staggering when contextualized against the average monthly salary in Ghana of around GHS 3,700. If an individual cannot pay, they face imprisonment. By international standards, these penalties are exceptionally punitive: in Switzerland, for example, possessing a small amount of cannabis results in a simple administrative fine of ........
As one official from the Narcotics Control Commission (NACOC) bluntly stated, "The users liable to pay fines for use aren’t usually in a position to pay... It’s the poorer people who have no choice but to smoke in the slums, in the streets, and so on who get caught." The system has merely created a different pathway to imprisonment for the poor.
5) A Flawed Path to Wellness: Punishment Before Treatment
The law's approach to rehabilitation contains a critical timing flaw. Under Section 45(5), the offer of treatment comes only after an individual has been prosecuted and convicted. A genuine public health model diverts people into the healthcare system instead of the criminal justice system, preventing the lifelong stigma of a criminal record. The current Ghanaian model is "punishment followed by an offer of treatment." It brands individuals as criminals first, creating immense barriers to future employment, education, and housing long after their sentence is served.
The Way Forward: Urgent Amendments to Save Lives:
To meet global goals to reduce draconian laws and stigma, Ghana must move beyond paper reforms. The following amendments are urgently needed to turn policy into life-saving practice, We need to:
1. Define the thresholds and fully decriminalize drug use: Parliament must urgently amend Sections 37, 41, and 45 of Act 1019 to specify drug quantities that distinguish personal use from trafficking. The ultimate goal should be the full decriminalization of possession and purchase for personal use; an approach aligned with recommendations from the the West African Commission on Drugs, the whole United Nations system, and the International Drug Policy Consortium, among many others. Personal use should not be an offense at all.
2. Rethink sentencing: The passage of the Non-Custodial Sentencing Bill is critical to provide genuine alternatives to incarceration for petty offenses. This will reduce prison congestion, save national resources, and allow the justice system to focus on serious crime.
3. Protect and expand harm reduction services: The law must be clarified to legally protect the distribution of medical supplies like sterile syringes and naloxone. These are not "drug tools"; they are life-saving medical supplies essential to preventing overdose deaths and the spread of disease.
4. Sensitize agencies: Law enforcement and security agencies require mandatory training to view people who use drugs as patients in need of referral to health services, not as criminals to be arrested.
Conclusion:
Ghana's Narcotics Control Commission Act 2020 is a law in conflict with itself. It was adopted as a result of progressive, health-oriented aspirations but these are being undermined by a punitive legal core that continues to criminalise and punish the very people it seeks to help.
The 2025 IBBS data are more than just numbers; they are a mirror reflecting a public health crisis fueled by our own draconian laws. Ghana took a courageous first step with Act 1019, signaling an intent to treat drug use as a health issue. But now, it must complete the journey.
By amending the law to prioritize health and compassion, Ghana can create a coherent and effective drug policy one that saves lives by supporting its most vulnerable citizens and focuses its law enforcement resources on the organized crime that poses a true threat to public safety.
By: Maria-Goretti Ane- Loglo Esq, Africa Consultant for the International Drug Policy Consortium (IDPC), and a lawyer, health and ethics advocate, and drug policy analyst from Accra, Ghana. Contact: mloglo@idpc.net