Ghana was promised a revolution. When the Narcotics Control Commission Act (Act 1019) was passed in 2020, it was hailed as a legislative masterpiece, a shift from the handcuffs of the past to the healing hands of public health. But beneath the celebratory rhetoric lies a jagged reality. While the law speaks the language of rehabilitation, its heart still beats with the pulse of prohibition. It is a law at war with itself, and in this internal conflict, it is the vulnerable who are losing.
The Act’s stated goals are progressive: to establish a dedicated rehabilitation fund and prioritise treatment and harm reduction over pure enforcement.
But a closer look reveals a profound and damaging contradiction. Despite these noble aspirations, the Act's punitive core remains firmly in place, creating a framework that is fundamentally at odds with its own health-focused mission. It espouses a new philosophy of care while clinging to an old regime of punishment.
"Plainly, there is a chasm into which policies fall on the way from the rhetoric to the reality." – Joanne Csete. 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.
This article explores the most surprising and impactful ways the law's reality fails to match its rhetoric, turning a promising reform into a system that can trap the very people it claims it wants to help.
Four Surprising Realities of Ghana's Reformed Drug Law
A 'Public Health' Law That Criminalises Patients
The fundamental conflict of Act 1019 is that it tries to walk in two opposite directions at once. On one hand, the Act mandates the Narcotics Control Commission to "ensure that substance use disorders are treated as a public health issue" (Section 3(i)). On the other hand, Sections 37, 41, and 45 of the very same law explicitly criminalise the personal possession and purchase of drugs.
This means the law prosecutes the exact individuals it claims it wants to help. Instead of establishing a "user-as-patient" paradigm, it reinforces the old "user-as-criminal" one. This approach is deeply counterproductive. The fear of arrest, prosecution, and a criminal record actively deters people from seeking the treatment and rehabilitation services the law supposedly supports, driving substance use further underground and increasing health risks.
The 'Alternative' to Jail Is a Fine Too High to Pay
One of the most celebrated features of Act 1019 was its introduction of non-custodial sentences for personal drug use, primarily through fines. However, the financial penalties are so severe they become an illusion of an alternative. The fine for possession for personal use is between GHS 2,400 and GHS 6,000. Even more staggering, the fine for purchasing drugs for personal use starts at GHS 24,000 and can reach GHS 120,000. If an individual cannot pay, they face imprisonment.
To put this in perspective, the average monthly salary in Ghana is around GHS 3,700. For many, especially those who are marginalised and struggling with substance use, paying such a fine is impossible. By international standards, these penalties are exceptionally punitive; in Switzerland, for example, possessing a small amount of cannabis results in a simple administrative fine. As one official from the Narcotics Control Commission (NACOC) bluntly told researchers from GITOC:
"The users liable to pay fines for use aren’t usually in a position to pay. If you are able to sit in a car or in your house to smoke, you won’t get caught. It’s the poorer people who have no choice but to smoke in the slums, in the streets, and so on who get caught."
Ultimately, the fine system disproportionately harms the most vulnerable. It does not provide a true alternative to incarceration but instead creates a pathway to "imprisonment by default," undermining the very goal of the reform.
A Vague Definition Turns Personal Use into Trafficking
Act 1019 fails to provide clear, quantified thresholds to distinguish between possessing drugs for personal use and possessing them for trafficking. The law’s definition for ‘possession for use’ is dangerously vague: ‘the possession or control of a quantity of narcotic drugs or plants which does not exceed the quantity which can reasonably be used by an individual in a day.’
What can "reasonably be used" in a day? The law doesn't say. This ambiguity leaves the critical distinction between a health issue and a serious felony entirely up to the discretion of the arresting officer on the street. 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.
This legal grey area also has unintended public health consequences, as it can perversely incentivise users to make more frequent purchases of smaller amounts, increasing their contact with criminal markets.
The devastating result of this legal ambiguity is not theoretical. During a focus group discussion, a judge recounted being forced by the law's rigid penalties to sentence a young woman to a mandatory minimum of 10 years in prison. Her crime was not trafficking for profit; it was sending a small amount of a drug to her boyfriend in prison, hidden inside a meal of “waakye." A simple act of personal connection was twisted by a poorly written law into a decade-long sentence, shattering a life over a legal grey area.
The Path to Treatment Starts with a Criminal Record
Section 45(5) of the Act contains what appears to be a health-focused diversion. It allows a court to order treatment and rehabilitation for someone convicted of purchasing drugs for personal use, an offense that, as noted, carries a potential fine of up to GHS 120,000. But the critical flaw lies in the timing: this offer of help comes after the person has already been prosecuted and convicted.
This is not a true diversionary program. 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 model in Ghana is "punishment followed by an offer of treatment." It requires an individual to be branded a criminal before they can be offered a path to wellness. This reinforces stigma and creates immense barriers to social reintegration, affecting a person's ability to find employment, pursue education, or secure housing long after their sentence is served.
Ghana's Narcotics Control Commission Act, 2020, is a law at war with itself. Its progressive, health-oriented aspirations are completely undermined by a punitive legal core that continues to criminalise and punish the very people it purports to help.
The only way to resolve this internal conflict and align the law with its own stated principles is to fully decriminalise the possession and purchase of drugs for personal use. This is not a radical idea but one aligned with regional best practices, such as those recommended by the West African Commission on Drugs (WACD) Model Drug Law, which states personal use should not be an offense at all. By adopting this change, Ghana can create a coherent and effective drug policy that truly prioritises health, reduces harm, and focuses its law enforcement resources on the organised crime that poses a far greater threat to public safety.
Can a law truly prioritise public health if it continues to criminalise the patient? Ghana's drug law needs an amendment to align the objectives of the law with realities! Rethink drug policy, amend Act 1019
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