Undoubtedly, the most prominent development we can see in global drug policy today is that more and more players, including countries, are admitting the need to move away from law-enforcement-dominated approaches in drug policy towards approaches that are based on public health instead.

Most notably, in recent years in Latin America there has been an intensifying debate about the failure of prohibition, and most recently even sitting presidents started loudly criticizing the ‘war on drugs’, saying that the Conventions should be more flexible to allow for experimentation with innovative approaches, especially where drug production and trafficking have caused a prolonged political and humanitarian crisis.

But what are these conventions that have bound the hands of politicians of decision-makers so much in Latin America and elsewhere?

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Recent trends in drug policy reform and UNGASS 2016

A bio-behavioral HIV survey among injecting drug users (IDUs) was carried out in October 2013 in Ramallah, Hebron, and Bethlehem governorates using time location sampling (TLS) methodology.

The study aimed to assess the prevalence of HIV, HBV, and HCV, as well as to analyze the patterns and correlates of HIV-relevant risk-taking behaviors. The study recruited 288 IDUs: 105 in Ramallah, 100 in Hebron, and 83 in Bethlehem.

Only one of the surveyed IDUs was female. Age range in the sample was 16-64, with the mean age of 39.2 (SD = 11.11; median age = 41). A majority of participants had only primary education or less (69.0%) and were married (59.7%). Only a quarter of the sample reported a full or part-time employment (26.2%).

No HIV cases were found in the study. Nineteen participants (6.6%) tested positive for hepatitis B surface antigen, while 117 participants (40.6%) tested positive for HCV. A small minority of participants (14.7%) answered correctly to all five standardized HIV knowledge questions (UNAIDS, 2013).

However, when asked specifically about HIV risks related to injecting drug use, most participants seemed well-informed: 94.1% correctly stated that HIV can be transmitted by syringe sharing, while 88.9% knew that sharing a needle or syringe washed in water may result in getting infected with HIV. HIV knowledge was highest in Bethlehem and lowest in Hebron, but the differences were slight.

Bio-behavioural HIV survey among injecting drug users in the West Bank, 2013 

There is an extensive body of literature documenting the stigma associated with alcohol and other drug problems. No physical or psychiatric condition is more associated with social disapproval and discrimination than substance dependence. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights.

Stigma and people who use drugs

The global war on drugs is severely jeopardizing the fight against AIDS. Criminalizing drug use drives the HIV pandemic not just among people who use drugs – but also among their families and communities.

Criminalization creates barriers to treatment and encourages unsafe injecting practices. Evidence consistently shows that repressive drug law enforcement practices are strongly associated with higher HIV rates. Fear of arrest drives many people who inject drugs into environments where HIV risks are greatly elevated, and away from HIV testing, prevention and other public health services. Criminalization also erects multiple barriers to both HIV and drug treatment. Research clearly demonstrates that people who use drugs tend to have lower rates of antiretroviral therapy utilization and higher rates of death due to HIV/AIDS.

The drug war: Fueling the HIV/AIDS pandemic

While men are more likely to be targeted by drug law enforcement, many of the drug war’s victims are women. Largely as a result of draconian drug laws, women are one of the fast growing segments of the U.S. prison population. Most women behind bars are mothers, many of them sole caregivers. Women, and particularly women of color, are disproportionately affected by drug law enforcement, by social stigma, by laws that punish those unable or unwilling to inform on others, by regulations that bar people with a drug conviction from obtaining public assistance, and by a drug treatment system designed for men.

Women, prison, and the drug war

After first attempting to prohibit various synthetic drugs, New Zealand realized that simply banning these substances was unrealistic and ineffective. In July 2013, the country’s Parliament enacted an historic new law that will regulate and control – rather than criminalize – so-called “bath salts” and other new synthetic drugs.

New Zealand's groundbreaking regulatory model for new synthetic drugs

The report presents a review of tools for monitoring illicit drug use in prison population in Europe. The objective of the report is to describe the existing tools used at national level, to assess their comparability and to build a common European basis for data collection on drug use and prison. The introduction includes the recent activities carried out in the last years at the EMCDDA, the formal mandate and the methodological developments. The report presents the assessment results by information area.

Drug use in prison: Assessment report

The EMCDDA has estimated annual public expenditure on drug-law offenders in prisons in Europe. Between 2000 and 2010, this expenditure is estimated to have been within the range of 0.03 % to 0.05 % of GDP, on average, in 22 European countries. By applying these percentages to the whole EU for the year 2010, it can be estimated that the expenditure was within the range of EUR 3.7 billion to EUR 5.9 billion. Based on data provided by Eurostat and the Council of Europe, the proportion of sentenced prisoners who have a drug-law offence as their main offence was applied to total public expenditure on prisons.

This study estimates how much 22 European countries spent on drug-law offenders in prisons during the last decade. Based on this, an estimate for public expenditure on drug-law offenders at the European level was made.

 Estimating public expenditure on drug-law offenders in prison in Europe

In March 2014, country delegations will gather at the United Nations Commission on Narcotic Drugs (CND) to review progress and challenges in international drug control since the agreement of a Political Declaration on drugs in 2009. Given that the Political Declaration aims to “eliminate or reduce significantly” the use, supply and demand of controlled drugs by 2019, this meeting represents an important opportunity for honest evaluation and an acknowledgement that these targets are not being achieved. With a United Nations General Assembly Special Session (UNGASS) on drugs just two years away, this is an important time for international drug control policy.

To support these deliberations, the United Nations Office on Drugs and Crime (UNODC) has released two important documents: a ‘Contribution of the Executive Director of the United Nations Office on Drugs and Crime to the high-level review of the implementation of the Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem’, and ‘Drug Policy Provisions from the International Drug Control Conventions’.

Both documents formalise an emerging rhetoric from UNODC that we have seen develop over recent years: that drug policies need to focus more on health than crime, but that the three international drug conventions – as they currently exist – provide sufficient flexibility to do this.

The changing rhetoric from the agency – of flexibility and health-based policies – is very much welcomed. Similar to the previous UNODC Executive Director’s acknowledgement of “unintended consequences” from drug policy,13 Mr Fedotov’s Contributions have the potential to push the debate forward in Vienna. However, the debate needs clearer legal analysis and more extensive normative guidance than the Drug Policy Provisions document currently provides.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

IDPC Advocacy Note - UNODC’s shifting position on drug policy: Progress and challenges 

The rise in methamphetamine use has provoked a barrage of misinformation and reckless policies, such as mandatory minimum sentences, increased penalties for minor offenders and major restrictions against certain medicines.

This new report, titled Methamphetamine: Fact vs. Fiction and Lessons from the Crack Hysteria, reveals the extreme stigmatization of users and dangerous policy responses that are reminiscent of the crack hysteria in the 1980s and 1990s, which led to grossly misguided laws that accelerated mass incarceration in the United States.

The report recommends that national and international policymakers review laws that harshly punish methamphetamine possession or use, invest in treatment rather than punishment, restudy the restriction of access to amphetamines for legitimate medical purposes, and stop supporting wasteful and ineffective campaigns of misinformation on methamphetamine use.

Methamphetamine: Fact vs. fiction and lessons from the crack hysteria

Unstable housing and homelessness are related to (former) injecting drug use, and stable housing is related to never-injecting drug use. Our study suggests that the number of ‘new’ IDUs is low. However, public injecting among IDUs is not uncommon and is associated with unstable housing. This emphasizes the potential of housing projects as a component of harm reduction measures.

Therefore, prevention of (risks associated with) injecting drug use and supported housing programmes for problematic hard-drug users deserve the continuous attention of policymakers and professionals in low-threshold addiction care. This study analyses the specific Dutch situation as regards a decrease in homelessness among problematic hard-drug users and an increasing focus on physical health in low-threshold addiction care.

Differences in sociodemographic, drug use and health characteristics between never, former and current injecting, problematic hard-drug users in the Netherlands

In 2011, Human Rights Watch released a shocking report on how Vietnamese citizens struggling with drug addiction were being beaten, tortured and forced to work in compulsory drug detention centers.

Vietnamese officials reacted defensively, dismissing the report as “groundless” and asserting that the drug
centers are an effective, humane method of dealing with a growing drug problem.

But new interviews with recently released drug center detainees confirm that forced labor, torture, and other human rights abuses continue in the centers, despite the government’s pledge to scale up voluntary forms of drug treatment. ILRF partners interviewed fifteen former detainees between June 2012 and June 2013. 14 of the 15 former detainees reported being forced to produce goods for private companies and over half had either witnessed a beating or been beaten themselves simply for missing an assigned work quota.

The documentation of continued abuses comes at a critical juncture, as Vietnam faces a dilemma over whether to ”renovate” its system of abusive drug detention centers or close them outright. In May 2012, twelve United Nations agencies released a joint statement calling for the immediate closure of compulsory drug detention centers. But within Vietnam, powerful constituencies, including the local officials who operate and profit from the drug centers, support their continued operation, making the prospects for real change uncertain.

Now is the time for the international community to send a clear message to the Government of Vietnam: forced labor cannot be legally or medically justified as “treatment” for drug dependence. International donor organizations, multinational companies that source from Vietnam, and the U.S. and EU should renew the call for immediate closure of drug detention centers.

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