Bastos’ article on structural violence and drug policy in contemporary Brazil raises a number of big questions that substance abuse researchers, particularly social scientists and public health researchers, should tackle to a greater extent than they have to date. The first big question raised by Bastos’ article is the extent to which international drug treaties influence, and often hamper, national drug policies that may reduce the harm associated with illicit drug use. As Bastos hints, more powerful countries (often those that have problems with “demand”) have more power to dictate the content of international drug treaties than poorer countries (often those that supply). International conventions have defined particular drugs as “illicit.” These treaties—and the recent history of Brazil’s dictatorship—have made drug reform “timid” at best. While drug reform has occurred, moving national law and policy from extremely punitive criminalization to some more tolerant and flexible approaches, these efforts have been hampered by local police enforcement and ambiguities in the law that allow judges considerable latitude in prosecution. For example, a number of state legislations protect the implementation of needle and syringe exchange programs (NSEP) to reduce druguse-related harms. In spite of this, national law has not protected outreach workers or NSEP, and outreach workers and users of these programs continue to be harassed by local police. Law 11343, passed in 2006, draws a distinction between personal use and trafficking with penal sanctions recommended only for the latter. However, the distinction between the two in terms of the amount or nature of the substance was not clear in this law, and left to an interpretation of “contextual factors” and the “personal characteristics and history of each individual” giving each judge considerable and somewhat arbitrary latitude in deciding who should be prosecuted as a drug trafficker.