Eurasian Harm Reduction Network Drug Policy Position paper

During the last twenty years, the region of Central and Eastern Europe and Central Asia (CEECA) has experienced an unprecedented growth in injection drug use — currently the region is home to 3.7 million people whoinject drugs. Among the most serious negative consequences is one of the world’s fastest-growing epidemics of HIV/AIDS and other blood-borne diseases: in Eastern Europe and Central Asia, one in four injectors is believed to be living with HIV. If the sharing of injecting equipment accounts for approximately 10% of HIV infections globally, in Eastern Europe and Central Asia in 2007, it accounted for 57% of infections for which the mode of transmission was known. In many respects this is due to harsh drug policies, which prohibit drug use and impose strict administrative and even criminal penalties for it. Several countries in the region employ a “zero tolerance” approach to drug use, which criminalizes drug use and institutes criminal liability for possession of very small amounts of any drug.

At the same time, the quality of health-related services and especially harm reduction for people who use drugs is often poor and service coverage inadequate. Harm reduction receives little or no funding from national governments in the region, demonstrating the lack of national commitment to the health of people who usedrugs. Not more than 10% of those in need have access to needle and syringe programs (NSP) in the CEECA region. Drug dependence treatment remains largely ineffective. In 2009, only 1% of all estimated people who inject drugs received opioid substitution therapy (OST). Hepatitis C treatment and overdose management receive inadequate attention from national governments, despite being significant health risks for people who use drugs. Notwithstanding this alarming public health situation, there is a worldwide resource-allocation imbalance of 3:1 in favour of spending on security and law enforcement rather than on public health.

The EHRN position is based on an evidence-informed approach and promotes the respect, observance and protection of human rights. EHRN’s overall goal as regards drug policy is to achieve a balanced and human rights-oriented drug policy that does not criminalize people who use drugs; that is conducive to providing them with adequate access to drug-dependence treatment, including OST and services for the prevention of blood-borne diseases and other health problems; and that protects human rights and reduces stigmatization and discrimination.