Parallel Universes: Human Rights and International Drug Control

This video produced by the Hungarian Civil Liberties Union highlights the human rights violations done against people all over the world as a result of the current international drug control system. The activists and researchers interviewed here recount the litany of abuses done in the name of drug control: torture, corporal punishment, overcrowding in prisons, death penalty for drug offences, denial of palliative care and HIV/AIDS treatment, among others.

As explained by the producers, the words of Paul Hunt, former UN Special Rapporteur on the Right to Health (2002-2008), at the 2008 Harm Reduction Conference are more valid than ever. The international drug control seems to be operating in a parallel universe from human rights law and it is the most vulnerable people who pay the price for this.

Click here to read Human Rights, Health and Harm Reduction: States’ amnesia and parallel universes, by Prof. Paul Hunt, member of the International Advisory Committee of the International Centre on Human Rights and Drug Policy.

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‘Children of the Drug War: Perspectives on the impact of drug policies on young people’ Damon Barrett (ed)

‘Children of the Drug War’ is a unique collection of original essays, edited by Damon  Barrett (Project Director at the International Centre on Human Rights and Drug Policy), that investigates the impacts of the war on drugs on children, young people and their  families. With contributions from around the world, providing different perspectives and utilizing a  wide range of styles and approaches including ethnographic studies, personal accounts and  interviews, the book asks fundamental questions of national and international drug control systems:

• What have been the costs to children and young people of the war on drugs?
• Is the protection of children from drugs a solid justification for current policies?
• What kinds of public fears and preconceptions exist in relation to drugs and the drug trade?
• How can children and young people be placed at the forefront of drug policies?

Four thematic sections address:

• Production and trade
• Race, class and law enforcement
• Families and drug policy
• Drug use and dependence

The book is published by the International Debate Education Association (iDebate Press). It is available for purchase in hard copy from amazon.com, amazon.co.uk and other outlets.

A pdf of the full book and pdfs of each of its four sections are available for free download. It may also be read online.

The right to heath and international drug control: Report of the UN Special Rapporteur on the Right to Health, October 2010

Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

UN Doc No A/65/255

Available in Arabic, Chinese, English, French, Spanish and Russian

Summary

The current international system of drug control has focused on creating a drug free world, almost exclusively through use of law enforcement policies and criminal sanctions. Mounting evidence, however, suggests this approach has failed, primarily because it does not acknowledge the realities of drug use and dependence. While drugs may have a pernicious effect on individual lives and society, this excessively punitive regime has not achieved its stated public health goals, and has resulted in countless human rights violations.

People who use drugs may be deterred from accessing services owing to the threat of criminal punishment, or may be denied access to health care altogether. Criminalization and excessive law enforcement practices also undermine health promotion initiatives, perpetuate stigma and increase health risks to which entire populations – not only those who use drugs – may be exposed. Certain countries incarcerate people who use drugs, impose compulsory treatment upon them, or both. The current international drug control regime also unnecessarily limits access to essential medications, which violates the enjoyment of the right to health.

The primary goal of the international drug control regime, as set forth in the preamble of the Single Convention on Narcotic Drugs (1961), is the “health and  welfare of mankind”, but the current approach to controlling drug use and possession works against that aim. Widespread implementation of interventions that reduce harms associated with drug use — harm-reduction initiatives — and of decriminalization of certain laws governing drug control would improve the health and welfare of people who use drugs and the general population demonstrably. Moreover, the United Nations entities and Member States should adopt a right to health approach to drug control, encourage system-wide coherence and communication, incorporate the use of indicators and guidelines, and consider developing a new legal framework concerning certain illicit drugs, in order to ensure that the rights of people who use drugs are respected, protected and fulfilled.

Recommendations

Member States should:

• Ensure that all harm-reduction measures (as itemized by UNAIDS) and drug-dependence treatment services, particularly opioid substitution therapy, are available to people who use drugs, in particular those among incarcerated populations.

• Decriminalize or de-penalize possession and use of drugs.

• Repeal or substantially reform laws and policies inhibiting the delivery of essential health services to drug users, and review law enforcement initiatives around drug control to ensure compliance with human rights obligations.

• Amend laws, regulations and policies to increase access to controlled essential medicines.

The United Nations drug control bodies should:

• Integrate human rights into the response to drug control in laws, policies and programmes.

• Encourage greater communication and dialogue between United Nations entities with an interest in the impact of drug use and markets, and drug control policies and programmes.

• Consider creation of a permanent mechanism, such as an independent commission, through which international human rights actors can contribute to the creation of international drug policy, and monitor national implementation, with the need to protect the health and human rights of drug users and the communities they live in as its primary objective.

• Formulate guidelines that provide direction to relevant actors on taking a human rights-based approach to drug control, and devise and promulgate rights-based indicators concerning drug control and the right to health.

• Consider creation of an alternative drug regulatory framework in the long term, based on a model such as the Framework Convention on Tobacco Control.

The Vienna Declaration: A Global Call to Action for Science-based Drug Policy

In Lead Up to XVIII International AIDS Conference, Scientists and Other Leaders Call for Reform of International Drug Policy and Urge Others to Sign-on

28 June 2010 [Vienna, Austria] – Three leading scientific and health policy organizations today launched a global drive for signatories to the Vienna Declaration, a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. Among those supporting the declaration and urging others to sign is 2008 Nobel Laureate and International AIDS Society (IAS) Governing Council member Prof. Françoise Barré-Sinoussi, co-discoverer of HIV.

The Vienna Declaration is the official declaration of the XVIII International AIDS Conference (AIDS 2010), the biennial meeting of more than 20,000 HIV professionals, taking place in Vienna, Austria from 18 to 23 July 2010.

“Many of us in AIDS research and care confront the devastating impacts of misguided drug policies every day,” said AIDS 2010 Chair Dr. Julio Montaner, President of the IAS and Director of the BC Centre for Excellence in HIV/AIDS. “These policies fuel the AIDS epidemic and result in violence, increased crime rates and destabilization of entire states – yet there is no evidence they have reduced rates of drug use or drug supply. As scientists, we are committed to raising our collective voice to promote evidence-based approaches to illicit drug policy that start by recognizing that addiction is a medical condition, not a crime.”

The Vienna Declaration describes the known harms of conventional “war on drugs” approaches and states:

“The criminalisation of illicit drug users is fuelling the HIV epidemic and has resulted in overwhelmingly negative health and social consequences. A full policy reorientation is needed…Reorienting drug policies towards evidence-based approaches that respect, protect and fulfill human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.”

Outside of sub-Saharan Africa, injecting drug use accounts for approximately one in three new cases of HIV. In some areas of rapid HIV spread, such as Eastern Europe and Central Asia, injecting drug use is the primary cause of new HIV infections. Legal barriers to scientifically proven prevention services such as needle programmes and opioid substitution therapy (OST) mean hundreds of thousands of people become infected with HIV and Hepatitis C (HCV) every year. The criminalization of people who inject drugs has also resulted in record incarceration rates placing a massive burden on the taxpayer. HIV outbreaks have also been reported in prisons in various settings internationally. This emphasis on criminalization produces a cycle of disease transmission, along with broken homes and livelihoods destroyed. Yet these costs, along with the more direct costs of the ‘war on drugs’, produce no measurable benefits.

“The current approach to drug policy is ineffective because it neglects proven and evidence-based interventions, while pouring a massive amount of public funds and human resources into expensive and futile enforcement measures,” said Dr. Evan Wood, founder of the International Centre for Science in Drug Policy (ICSDP) and Clinical Associate Professor at the University of British Columbia. “It’s time to accept the war on drugs has failed and create drug policies that can meaningfully protect community health and safety using evidence, not ideology.”

The Vienna Declaration calls on governments and international organizations, including the United Nations, to take a number of steps, including:

• undertake a transparent review the effectiveness of current drug policies;
• implement and evaluate a science-based public health approach to address the harms stemming from illicit drug use;
• scale up evidence-based drug dependence treatment options;
• abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights; and
• unequivocally endorse and scale up funding for the drug treatment and harm reduction measures endorsed by the World Health Organization (WHO) and the United Nations.
• The declaration also calls for the meaningful involvement of people who use drugs in developing, monitoring and implementing services and policies that affect their lives.

“As a scientist, I strongly support drug policies that are based on evidence of what actually works,” said Prof. Françoise Barré-Sinoussi, Director of the Regulation of Retroviral Infections Unit at the Institute Pasteur, IAS Governing Council member and recipient of the 2008 Nobel Prize for Medicine. “I join with my colleagues around the world today to sign the Vienna Declaration in support of science-driven policies and human rights.”

The effectiveness of opioid substitution therapy (OST) and needles and syringe programmes is well-documented, though access to such interventions is often limited where HIV is spreading most rapidly. According to various scientific reviews conducted by WHO, the US Institutes of Medicine and others, these programmes reduce HIV rates without increasing rates of drug use. These cost-effective interventions also produce significant savings in future health care costs, and help people who use drugs access health care and drug treatment. No evidence exists demonstrating negative consequences of use of these programmes.

“Reflecting the AIDS 2010 theme of Rights Here, Right Now, the Vienna Declaration is rooted in the belief that global drug policy must respect the human rights of people who use drugs if it is to be at all effective,” said AIDS 2010 Local Co-Chair Dr. Brigitte Schmied, President of the Austrian AIDS Society. “No one who is familiar with addiction would deny the negative impacts it has on individuals, families and entire communities, but those harms do not justify human rights violations. People addicted to illicit drugs have the right to evidence-based drug treatment, to interventions to prevent infection, and, if they are living with HIV, to antiretroviral treatment.”

The Vienna Declaration was drafted by an international team of scientists and other experts, many of whom will participate in AIDS 2010 next month. It was initiated by the International AIDS Society (IAS), the International Centre for Science in Drug Policy (ICSDP), and the BC Centre for Excellence in HIV/AIDS based in Vancouver, British Columbia.

Those wishing to sign on may visit www.viennadeclaration.com, where the full text of the declaration, along with a list of authors, is available. The two-page declaration references 28 reports, describing the scientific evidence documenting the effectiveness of public health approaches to drug policy and the negative consequences of approaches that criminalize drug users.

Harm reduction and the right to health – recent recommendations of UN human rights mechanisms

In 2009 the UN Special Rapporteur on the Right to the Highest Attainable Standard of Physical and Mental Health, Anand Grover, undertook a mission to Poland. the final report of the mission will be presented to the Human Rights Council at its 14th Session which is currently taking place. It includes strong recommendations relating to harm reduction services such as needle and syringe exchange and opioid substitution therapy, as well as criminal laws surrounding drug use and possession.

The Special Rapporteur urges Poland to consider the following recommendations in the area of harm reduction policies and practices:

(a) Ensure that needle and syringe programmes, opioid substitution therapy and other harm reduction strategies become widely available throughout the country.

(b) To establish, without further delay, an opioid substitution programme in the Tri-City region of Gdansk, Sopot and Gdynia.

(c) Amend the National Law on Counteracting Drug Addiction to avoid penalization of the possession of minute quantities of drugs, in order to foster access to substitution therapy for people using drugs.

(d) Ensure the informed and active participation of people using drugs and other marginalized groups at the national, regional, and local level in the establishment of policies and programmes.

(e) Include the participation of people living with HIV and those groups most at risk of HIV in HIV/AIDS-related educational projects and campaigns.

(f) Ensure the enactment and implementation of a comprehensive anti-discrimination and equality law to help ensure the full enjoyment of the right to health, based on equality and non-discrimination within the State.

In May 2010, Mauritius was before the UN Committee on Economic Social and Cultural Rights as part of its periodic review process. The Committee raised a series of concerns related to Mauritian drug policies and the ‘alarmingly high’ rate of injecting drug use and related HIV in the country. Concerns were also raised about recent announcements to reintroduce the death penalty for drugs.

27. The Committee is concerned at the alarmingly high number of injecting drug users in the State party. It is further concerned at reports that the National Drug Control Masterplan 2008-2012 was never officially endorsed and is not being used by the various stakeholders concerned. The Committee is also concerned about the sharp increase in cases of HIV/AIDS, particularly concerning intravenous drug users, sex workers and prison inmates. (art. 12)

The Committee recommends that the State party undertake a comprehensive approach to combat its serious drug problem. In order to achieve the progressive realisation of the right to health for people who inject drugs and so that this group may benefit from scientific progress and its applications (article 15.1.b), the State party should implement in full the recommendations made by the WHO in 2009 designed to improve availability, accessibility and quality of harm reduction services – in particular needle and syringe exchange and opioid substitution therapy with methadone. People who use drugs should be a key partner in this initiative. As a matter of urgency, the State party should:

(a)Scale up needle and syringe programmes to all geographical areas. The Government should amend the Dangerous Drugs Act 2000 to remove prohibitions on distributing or carrying drug paraphernalia as these impede HIV prevention services;

(b)Implement pilot prison needle and syringe exchange and opioid substitution therapy programmes based on international best practice standards;

(c)Remove age barriers to accessing opioid substitution therapy and develop youth-friendly harm reduction services tailored to the specific needs of young people who use drugs;

(d)Remove restrictions on access to residential shelters for women who use drugs;

(e)Make hepatitis C treatment freely available to all injecting drug users; and

(f)With regard to addicted persons, consider the decriminalisation and related public health based measures such as prescription of buprenorphine.

28. The Committee is concerned at the high and increasing rate of drug trafficking and related corruption in the State party. (art. 12)

The Committee recommends that the State party take the necessary measures to combat drug trafficking and related corruption. At the same time, the Committee recommends that these measures fully comply with the international human rights standards, including in relation to the abolition of the death penalty.

At the same session, the Committee recommended that Kazakhstan scale up access to opioid substitution therapy with methadone

Drug control, crime prevention and criminal justice: A Human Rights perspective

New paper by the United Nations Office on Drugs and Crime and released this week at the 53rd session of the UN Commission on Narcotic Drugs. This is UNODC’s most comprehensive and detailed treatment of human rights issues and obligations in the context of drug control.

UNODC Human Rights Conference Paper

Report of the Special Rapporteur on torture Manfred Nowak, 2009 – Applying a Human Rights-based approach to drug policy

In this 2009 report to the UN Human Rights Council, the United Nations Special Rapporteur on torture, Professor Manfred Nowak, calls on UN member states to adopt a rights based approach to drug policies.

Recognising that the human rights and drug policy regimes in the UN have ‘evolved practically detached’ from each other, Prof Nowak’s report submitted for the 10th session of the Council draws the attention of members states to the issues of ‘drug users in the context of the criminal justice system and situations resulting from restricted access to drugs for palliative care.’

In specific, the Special Rapporteur raised concerns relating to:

• The use of the death penalty for drug offences
• Denial of access to opioid substitution therapy and needle exchange in places of detention
• Forced drug dependence treatment
• Forced testing for HIV and HCV
• Lack of access to opiates for pain relief

SR Torture Report A.HRC.10.44AEV

Letter from UN Special Rapporteurs on Health and on Torture to the UN Commission on Narcotic Drugs

In this letter to the Chairperson of the UN Commission on Narcotic Drugs (CND) dated 10 December 2008, the United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment,  Professor Manfred Nowak, and  Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Mr Anand Grover,  ‘offer guidance’ regarding human rights issues that arose during the UN’s ten-year drug strategy review.

The letter offers comment on a draft of the political declaration on drugs that was then being prepared for discussion at a High Level Meeting on Drugs to be held in Vienna in March 2009.  It addresses issues such as harm reduction, extradition, ensuring access to essential medicines and drug dependence treatment. The letter was intended to ensure ‘consistency with international commitments and obligations relating to human rights’ in a new political declaration’.

SpecialRapporteursLettertoCND012009

Ethical and human rights imperatives to ensure medication-assisted treatment for opioid dependence in prisons and pre-trial detention, R. Douglas Bruce and Rebecca Schleifer

International Journal of Drug Policy 19 (2008) 17–23

Abstract

Opioid dependence is a complex medical condition affecting neurocognitive and physical functioning. Forced or abrupt opioid withdrawal may cause profound physical and psychological suffering, including nausea, vomiting, diarrhoea, extreme agitation and/or anxiety. Opioid dependent individuals are especially vulnerable at the time of arrest or initial detention, when they may, as a result of their chemical dependency, be coerced into providing incriminating testimony, or be driven to engage in risky behaviour (such as sharing needles in detention) in order to avoid painful withdrawal symptoms.

Upon incarceration, many opioid-dependent prisoners are forced to undergo abrupt opioid withdrawal (both from legally prescribed agonist therapy such as methadone as well as illicit opioids). Physical and psychological symptoms attendant to withdrawal may impair capacity to make informed legal decisions, and cause prisoners to risk HIV and other blood-borne diseases by sharing injection equipment. Although prisons must provide at least the standard of care to prisoners that is available in the general population, medication-assisted treatment, endorsed by international health and drug agencies as an integral part of HIV prevention and care strategies for opioid-dependent drug users, is unavailable to most prisoners.

Medication-assisted treatment is a well-studied and validated pharmacological therapy for the medical condition known as opioid dependence.

The failure to ensure prisoner access to this medical therapy threatens fundamental human rights protections against cruel, inhuman or degrading treatment and rights to health and to life. It also poses serious ethical problems for health care providers, violating basic principles of beneficence and non-maleficence (i.e., do good/do no harm). Governments must take immediate action to ensure access to opioid substitution to prisoners to ensure fulfilment of ethical and human rights obligations.

Download via the International Journal of Drug Policy