How do you care for a patient in pain? It’s a deceptively complicated question—one that garners vastly different responses depending on where you are in the world. In some places, pain is poorly understood, and medicines to relieve pain are unavailable or stigmatized.

Dr. M.R. Rajagopal is the founder and chairman of Pallium India, a palliative care organization emphasizing compassionate care and working to ensure patients are offered adequate treatment for their pain. Dr. Rajagopal has dedicated decades to ensuring quality of life for his patients and is a committed advocate for better access to controlled medicines—particularly morphine, an affordable and effective, yet highly stigmatized, treatment.

In 80 percent of the world, political, regulatory, and social barriers—often related to the UN’s International Drug Control Conventions—mean that patients do not receive medication for pain relief. “This is a global issue,” Dr. Rajagopal says. “It really hurts in developing countries.”

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A push for balanced drug policy is transforming pain relief in india

15 March 2016 - Alternatives to conviction or punishment, where appropriate, can be pursued by countries under the international drug control conventions, the head of UNODC, Yury Fedotov, stressed today at a side event on the margins of the 59th session of the Commission on Narcotic Drugs (CND).

Mr. Fedotov highlighted the need to consider alternatives to imprisonment as a means of "helping to address prison overcrowding, and potentially prevent the recruitment of vulnerable individuals in detention by criminals and terrorists."

The discussions ahead of the UN General Assembly Special Session (UNGASS 2016), to be held in April this year, he said, showed that the three international drug control conventions are driven by a concern for the health and welfare of humankind. He noted that a balanced approach necessitated applying the principle of proportionality to drug-related offences and offenders.

"Disproportionate responses do not serve the cause of justice, nor help to uphold the rule of law. In this regard, the application of the death penalty to drug-related offences has never been in the letter or the spirit of the conventions," underscored Mr. Fedotov.

People suffering from drug use disorders also need comprehensive health and social services that are voluntary, rights-based, accessible, effective and affordable. This required, Mr. Fedotov said, justice, health and social service actors to work together in close coordination.

Thumbnail: Commission on narcotic drugs - UNIS Vienna

UNODC: Disproportionate responses to drug related offences do not serve justice

Автор блога: Даша Матюшина, Советник по реформированию политики

Вернувшись с 59-ой сессии Комиссии ООН по наркотическим средствам (КНС) больше недели назад, я все никак не могла собраться с мыслями и решить, что именно написать о КНС в рассылку ЕССВ. И ведь много интересного было на КНС – наша региональная сессия, прекрасная речь Славы Селларса на пленарной сессии,выступление Оли Пономаревой на сессии по проблемам женшин, употребляюших наркотики, и кулуарные обсуждения итогового документа UNGASS. Но чем поделиться в формате короткого блога? Что такового важного о процессах формирования международной наркополитики я узнала в Вене, и о чем непременно стоит знать тем, кто в Вене не был?

Расстановка сил все та же, что и 13 лет назад, когда я впервые приехала на КНС – Евросоюз за снижение вреда, Россия – против, США в целом «за», но отказываются снижение вреда называть снижением вреда. В прошлом году мы были счастливы услышать сильное выступление Латвии, бывшей тогда председателем Совета ЕС, в поддержку снижения вреда и необходимости соблюдении прав человека в контексте наркополитики. В этом году порадовала речь Чехии на пленарном заседании КНС, в которой четко изложено влияние снижения вреда на страновом уровне: тот факт, что в Чехии «очень низкие социальные и экономические издержки, связанные с употребление нелегальных наркотиков», правительство объясняет не тем, что Чехия – страна, «свободная от наркотиков», а целенаправленным внедрением программ снижения вреда. В выступлении Словении все разложено по полочкам – цитирую: «необходимо подчеркнуть, что опиатная заместительная терапия является самой изученной и успешной программой лечения [наркозависимости]»; цель декриминализации хранения небольшого хранения наркотиков, которую Словения провела еще в 1999 году, в том, чтобы «поощрить лечение» зависимости. Упомянуто снижение вреда и в пленарном выступлении Польши.

От стран региона, не входящих в ЕС, мы слов поддержки в адрес снижения вреда на пленарной сессии не услышали. Что, в общем, не удивительно в случае России и Узбекистана. Новый глава Агентства по контролю за наркотиками Таджикистана Шерхон Салимзода ограничился упоминанием усиления работы по«снижению … негативного влияния [наркотиков] на безопасность здоровья населения» как результата реализации национальной антинаркотической стратегии.

Оставайтесьвкурсесобытийнаркополитики, подписавшисьна

Thumbnail: Website of the Eurasian Harm Reduction Network

Большая наркополитика: успеть за 30 секунд

By Dasha Matiushina, Policy Reform Advisor

Since my return from the 59th session of the UN Commission on Narcotic Drugs (CND) over a week ago, I haven’t been able to collect my thoughts and decide what exactly I should write about the CND for the EHRN mailing list. However many interesting things happened at the CND – our regional session,Slava Sellars’ great speech at the plenary session, Olya Ponomaryova’s speech at the session on the issues of women who use drugs and behind-the-scenes discussions of the UNGASS outcome document – how can those things be shared in a short blog format? What were the important things I learned in Vienna about the processes of forming the international drug policy? And what should those who weren’t there definitely be made aware of?

The balance of power is the same as 13 years ago when I first came to the CND – the EU supports harm reduction, Russia is against it, the USA supports it in principle but refuses to call it harm reduction. Last year we were happy to hear a strong statement by Latvia (then helding Presidency of the Council of the EU) in support of harm reduction and the need to protect human rights in the drug policy context. This year the Czech Republic’s statement at the plenary session made us happy; it clearly described the impact harm reduction has at the country level: the government explains that the Czech Republic experiences “extremely low social and economic costs related to the use of illegal drugs” because it’s a “drug-free” country but because it focuses on introducing harm reduction programs. Slovenia’s statement is also very clear; here’s a quote: “It’s necessary to emphasize that opiate substitution therapy is the best-studied and the most successful treatment program [for drug dependency]”; the goal of decriminalizing possession of small amounts of drugs in Slovenia back in 1999 is to “encourage” drug treatment. Poland’s statement also mentions harm reduction.

As for non-EU member countries from our region, at the plenary session we didn’t hear them utter words of support for harm reduction. Which isn’t surprising when we talk about Russia and Uzbekistan. The new head of the Drug Control Agency of Tajikistan Sherkhon Salimzoda limited himself to mentioning the intensification of the work to “reduce… the negative impact of [drugs] on people’s health safety” as a result of implementing the national drug strategy.

Global drug policy: In 30 seconds or less

The Global Drug Policy Program and Release are proud to invite applications to the 

2016 Asia & Africa Advocacy Fellowship Program on Drug Policy Reform

. Fellows will be hosted by and at Release in London, the UK’s center of expertise on drugs and drugs law. This program supports those working in sectors related to drug policy in order to increase their understanding of international drug policy reform issues, improve their advocacy skills, and enhance their capacity in working with the media on drug policy. The fellowship seeks to increase the capacity of emerging and new leaders in drug policy reform, including people not necessarily working full-time on drug-related issues.

The objectives of the fellowship include the following:

increase their knowledge of global drug policy reform issues on a region-by-region approach

increase their understanding of the international drug control system and conflicts with other United Nations priorities

have a greater awareness of the drug policy reform landscape and key figures within that movement

establish links with those working in drug policy, particularly in the UK

build and develop their communications skills, including for media interviews, press releases, press databases, public speaking

have an understanding of the tools for debate, so that they can confidently challenge anti-reform positions

improve their confidence as drug policy advocates both through participation in the program and through ongoing support from the host organization

Successful candidates will have a track-record of public engagement in the issues of drug policy reform or another relevant field (e.g., public health) at the local, national, or international levels.

Applications are welcome from those working across numerous fields related to drug policy. Previous fellows have worked in drug policy NGOs, at law enforcement agencies, in national governments, in health care facilities, and at universities, among other organizations. Please note that before receiving the fellowship, finalists will be asked to present a letter from their employer agreeing to their two-week participation in the course.

The purpose of this program is to promote the capacities of both new advocates and individuals who are emerging leaders in drug policy reform. Starting in 2016, employees of organizations currently receiving support from the Open Society Foundations are eligible to apply for the fellowship.

Asia & Africa advocacy fellowship program on drug policy reform

The mountains meet the Indian Ocean on the Wild Coast. At Ebulawu, south of Port St Johns, green-topped peaks undulate up towards sheer drops into the blue maelstrom below, where waves crash against cliffs of white, grey and red.

Vines hang heavy on centuries-old trees. The vegetation's lush hypnotism is a reminder that this is psychotropic territory in every sense. The descent into the ravines takes us down paths darkened by impenetrable tree canopies.

Forests give way to clearings, which give way to squares of crops - and back again. Navigating down the steep inclines, one is soon walking in fields of marijuana, where stalks are star-spangled with leaves and crystalline flowering buds. Some plants are shoulder high, others are stunted by drought.

Ebulawu is one of the heartlands of Pondoland marijuana. These are fields of green.

 cultivated at Ebulawu have been famous for generations. Locals, tourists, visiting fishermen and dealers have been buying, smoking and selling the marijuana for decades. Some locals barter their crops for anything from food to appliances. Customers come from as far away as Pretoria and Cape Town to buy bulk for resale.

"My grandfather planted before me, I remember he planted three or four mountains away from here," says Michael*, 62, pointing northward. "My father didn't plant at all. I didn't either, until I came back from the mines in 1989."

Michael had been working as a miner in Welkom when he was retrenched. He says one day his benefit pay-outs stopped - with no explanation. To supplement an income from catching and selling fish to tourists - and to support his nine children - Michael began growing marijuana.

Employment in the area is limited to cleaning the cottages that white tourists and anglers have built on land obtained on long-lease from local chiefs, sometimes in exchange for alcohol and a feast for the village. Or selling the abundant harvest of fish, mussels and shellfish to tourists - the going rate for a whole steenbras the length of one's forearm, says Michael, is about R50.

There are no other jobs in this lush paradise. Men will go to the mines if they can, committing themselves to the penury of hard migrant labour, only seeing their families two or three times a year. Women will tend the fields growing mealies, spinach, cabbage and vegetables for subsistence. Money for clothes, school uniforms and books or cellphone airtime comes from social grants, seafood sales - and marijuana.

Killing the economic lifeblood of the Eastern Cape's weed-producing people

The first country in the world to legalize marijuana sales was Uruguay, a tiny South American nation with a population of only 3.3 million wedged between Brazil and Argentina.

Uruguay fully legalized the production and sale of marijuana in December 2013 after a decade-long grassroots movement headed by mostly middle-class consumers managed to convince the government it was safer to legally sell weed rather than to allow drug dealers to run the market.

The system now in place grants licenses to private producers for large-scale cannabis farming and regulates its distribution at a controlled price of about one dollar a gram through pharmacies to registered consumers.

Private individuals are also allowed up to six plants at home. Larger amounts can be grown at “cannabis clubs” where individuals band together to produce marijuana in greater quantities as long as it is not for sale.

Legal sales through pharmacies are expected to begin in the second half of this year. Earlier this month the government opened the registry for pharmacists wishing to sell legal weed. These must install fingerprint recognition software to identify consumers as well as wall-mounted safety boxes to protect the maximum two kilos of marijuana each pharmacy will be allowed to maintain in stock.

Consumers must register with the government and will be allowed to purchase 10 grams per week.

Private consumption of drugs of any kind – including heroin and cocaine – was never actually banned by law in this atypically liberal South American nation, but the commercial production of marijuana was prohibited until the new law three years ago.

Uruguay's legal marijuana policy en route to next phase of regulation

Countries agree on outcome document for adoption at UNGASS 2016

VIENNA, 23 March (UN Information Service) - The 59th Session of the Commission on Narcotic Drugs (CND) closed today with a reminder of the UN General Assembly Special Session on the world drug problem (UNGASS 2016) to be held in April this year.

"The 59th Session was especially important given that we now stand on the threshold of UNGASS 2016, which is to be held in New York next month," said the Executive Director of the UN Office on Drugs and Crime (UNODC), Yury Fedotov, in his closing remarks.

Commenting on the finalisation by Member States of the outcome document, he said, "I warmly welcome the agreement on the outcome document to be adopted at UNGASS 2016 in New York in April. The document can now be used to forge the action needed to assist millions of women, children, and men around the world."

"I also see this April's UNGASS as a moment in time to create the necessary cooperation to address the world drug problem, to link our activities to the UN's overall work of achieving sustainable development, and to build momentum towards 2019 and the review of the Political Declaration and Plan of Action on the world drug problem," said Mr. Fedotov.

Mr. Fedotov expressed his thanks to the representatives of member states for their efforts during the deliberations. "You have laboured long and hard to build a constructive dialogue. I applaud these endeavours," said Mr. Fedotov.

A number of resolutions, including the outcome document for UNGASS, were passed at the 59th Session of the CND on matters ranging from mainstreaming gender perspectives into drug-related policies and programmes, to development and dissemination of the international standards of treatment of drug use disorders. Other topics of the resolutions passed included alternative development, and strategies for improving health and social wellbeing.

Seven substances were also scheduled under the international drug control conventions by the CND following recommendations by the World Health Organization's Expert Committee on Drug Dependence.

Over 70 side-events and more than 30 exhibitions were held during the 59th Session, which was attended by more than 1,500 people representing member states, civil society, academia and international organizations.

In closing his remarks, Mr. Fedotov told delegates, "I look forward to meeting you again in New York next month at UNGASS 2016 as you continue the vital work of enhancing global approaches to international drug policy."

Click here to access the press release online.

59th CND Session closes with eye on April's UNGASS 2016

Today, the United States Supreme Court declined to hear the case brought by Nebraska and Oklahoma against Colorado over its marijuana legalization law. Oklahoma and Nebraska had claimed the Colorado law had created an increased law enforcement burden in neighboring states. The suit, filed by Nebraska Attorney General John Bruning and Oklahoma Attorney General Scott Pruitt, claimed that federal marijuana prohibition preempts the law that Colorado voters decisively adopted in 2012. The Federal Government filed a brief urging the high court to reject the case.

Statement from Tamar Todd, Director, Office of Legal Affairs of the Drug Policy Alliance:

“The Supreme Court’s rejection of this misguided effort to undo cautious and effective state-level regulation of marijuana is excellent news for the many other states looking to adopt similar reforms in 2016 and beyond. Other states are looking to what Colorado has accomplished: the drops in racially disparate arrests, the criminal justice dollars saved, and the tax revenue raised and want to adopt similar marijuana law reforms. The dismissal of this action means that the four states that have adopted ballot initiatives by decisive margins to tax and regulate marijuana for adults, as well as the many states that have adopted laws to regulate medical marijuana, can proceed without interference at this time.

“The Federal government itself filed a brief with the high court asking that it not hear this case. It has not challenged the regulatory law in Colorado nor did it choose to interfere with its implementation. To the contrary, the government has deprioritized enforcement of state-level marijuana reforms and acknowledged the interests that both states and the Federal government have in openly regulating marijuana.”

Supreme court rejects Nebraska and Oklahoma lawsuit over Colorado marijuana legalisation

The so-called War on Drugs has been lost. So what now?

That’s the vexing question United Nations member states have been grappling with over the past 10 weeks, as they have engaged in intense negotiations over the future of the international response to drugs, in preparation for a UN General Assembly special session in April.

Confronted with the fact that policies pursued over the last 50 years have failed to “eliminate or significantly reduce” illicit drugs, countries are drawing wildly differing conclusions. For some, it is time to try something new; for others, it’s to double down on the criminal law enforcement approach. On opposite sides of this debate are countries like Uruguay – open to legalization and regulation of marijuana – and Russia, which opposes even references to a previously agreed – and spectacularly missed – global goal to reduce drug-related HIV transmission.

Health and human rights are at the center of this polarized debate. The UN drug control conventions were established, along with the UN Office on Drugs and Crime and the International Narcotics Control Board, out of concern for the harms drugs can do to the “health and welfare of mankind.” But with a growing body of evidence highlighting the negative impacts on health and human rights of an over reliance on a criminal law enforcement-based response to drugs a critical question has arisen: What does more harm – drugs themselves or the response to them?

In the run-up to the April meeting, Human Rights Watch will publish a series of articles examining the range of serious human rights abuses – from torture and killings in the name of drug control to disproportionate and arbitrary imprisonment of drug users to denying cancer patients access to morphine for pain – the War on Drugs has caused. Ending these abuses need to be at the center of the deliberations at the UN General Assembly session on drugs.

The war on drugs – A cure worse than the disease

At around 23:00 delegations left informal negotiations agreeing on a final outcome document. Switzerland made a reservation, pending on approval of the government, on the preambular paragraph 7 mentioning a society free of drug abuse, wanting to include a mention on responding to the public health and social problems resulting from drug abuse. While the intention was to present a short and concise outcome document with operational recommendations, a 24 page document was presented at the Plenary.

The EU, supported by among others Turkey, Switzerland, Canada, Costa Rica, Mexico, Colombia and Chile, gave a statement about the failure to include language opposing the death penalty, regretting that the document did not include language about the abolition of the death penalty and called on countries to adopt a moratorium on the execution of the death penalty. Brazil, New Zealand, Australia and Norway made a similar statement. Indonesia made a statement that there is no consensus on the abolition of the death penalty and that the issue is not part of the mandate of the CND, and is a criminal justice matter of sovereign states, supported by China, Pakistan, Egypt, Malaysia and almost all Arabic states.

Colombia, Mexico, Guatemala, Ecuador,Panama, Switzerland and others made a statement that although the outcome document is a step forward, because of the consensus process some issues were not included and called for a broad comprehensive approach towards 2019 and beyond, paying particular attention to the 2030 SDG targets. China pointed to the emerging challenges of NPS.
Reform minded delegations think there is sufficient progress to build on towards the evaluation of the 1998 UNGASS at the High Level Segment in 2019. The document mentions persistent, new and evolving challenges to be addressed in conformity with the three international drug conventions, which allow for sufficient flexibility to State parties to design and implement national drug policies. It does not mention harm reduction but there is mention of appropriate medication-assisted therapy and injecting equipment programmes, the new diplo-speak for opioid assisted therapy and needle and syringe exchange.

TNI at CND 2016: Reports from Vienna

From April 19–21, global leaders will meet for the first time in 18 years to debate global drug policy at the U.N. General Assembly Special Session on the World Drug Problem in New York. As soon as this week, the 59th session of the Commission on Narcotic Drugs will have the opportunity to decide whether the U.N. session will truly be “special” in achieving tangible results – or not.

 special in bringing strong outputs based on reality, the global regime will incorporate human rights and public health into current drug policies. Weak and blurred outputs would mean that the same regime has proved unable to adapt itself to the changing world and is doomed to collapse.

The special session on drugs is gathering at the request of three Latin American countries that are suffering from the war on drugs: In Mexico alone, the number of homicides related to the war on drugs exceeds the number of casualties of the wars in Syria, Iraq and Afghanistan combined. And yet, all around the world, we see results of the dysfunctional drug control regime: “Illegal drugs” were never as available or cheap or used as much as they are today.

The war on drugs is not only a problem for developing countries. To rely on tough prohibition is far too expensive even for the wealthiest nations. As President Obama recently noted, the war on drugs has been “very unproductive.” Indeed, it is causing even more crime than it seeks to prevent and diverts limited law enforcement resources from urgent issues, no matter whether the country is wealthy or not. Looking back, we can see our current situation is promising: While President Nixon declared a “war on drugs” in 1969, and President Reagan further expanded drug control measures outside the US, the current U.S. commander-in-chief clearly understands that this war should have ended long ago. Now we need to see that this rhetoric is followed by energetic action.

So far, we have seen minimal amounts of progressive language in the working versions of the output document to be debated and adopted at the U.N. special session on drugs. Interestingly, those countries experimenting most intensively with different drug control regimes are silent on the conflict between their progress and the current structure and interpretations of the U.N. conventions on drugs.

This applies, first of all, to the U.S., with four of its states and even its capital city legalizing recreational marijuana – the most widespread illegal drug – and with another four to nine states expected to do so in 2016. Make no mistake: The global drug policy is the responsibility of the whole global community. However, the U.S. is the only superpower to have invented, promoted and globally exported the war on drugs.

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