This chapter examines the origins of the global drug control regime that was established between 1961 and 1988, the cornerstone of which is the Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances 1988 (the Trafficking Convention). It attempts to explain how the humanistic and philanthropic enterprise represented by the Trafficking Convention and supported by overwhelming international sentiment has become distorted by state policy and organised crime to become the source of wars, offending, disease, and loss of life on an unprecedented scale. It suggests that the unremittingly penal and prohibitive approach to the problem of illicit drugs represented by the Trafficking Convention has served only to magnify the criminality associated with drug trafficking and it concludes by considering the ways in which states have sought to escape from the Convention’s restrictions as well as investigating contemporary moves for reform.