Health should be at the centre of the global drug policy debate. After all, the primary reason for the creation of the UN drug control regime is the protection of the ‘health and welfare of mankind’, as the preambles of the 1961, 1971 and 1988 UN drug conventions put it. As the lead entity on health matters within the UN system, the World Health Organization (WHO) is uniquely placed to fulfil a broad mandate in articulating a more progressive approach that truly puts people’s health, wellbeing and human rights at the centre of drug policies.

Yet, the role of the WHO in global drug policy has been surprisingly limited. This may be the result of a number of factors, including the minimal role that the UN drug control conventions assign the WHO, political obstruction by UN member states that prefer to perpetuate Vienna’s monopoly on drug-related issues, and a reluctance in recent decades of the WHO’s leadership and its governing bodies to proactively claim a role that reflects the centrality of health in drug policy. The WHO’s mandate on drugs issues, however, does not only derive from the UN drug conventions, but also from its role as the lead agency of the UN on health, and its own Constitution.

In this advocacy note, IDPC discusses the WHO’s strategic role in drug policy, including progress made and ongoing gaps and challenges, and calls on the WHO and its governing bodies to engage in a more progressive and systematic way in various aspects of global drug policy to ensure more coherence with the UN system on drug policy, health, human rights, and the achievement of the Sustainable Development Goals.

Strengthening the role of the World Health Organization in global drug policy

Celebrating its 50th anniversary, the International Narcotics Control Board (INCB or Board, see Box 1) today finds itself operating within a UN-based international drug control system facing unprecedented challenges; challenges that stem not only from a growing and increasingly complex global drug market, but also a divergence of views among member states on how best to deal with it. It is within this context that March 2019 saw the publication of the Board’s Annual Report for 2018.

The Annual Report represents a key document within the UN drug control system. It plays an important role in not only providing an analysis of the ‘drug control situation world-wide and potential situations that may endanger the objectives of the international drug control treaties’, but also in setting the subsequent tone of debates and identifying areas that it feels are of concern.

As can be seen over the past 45 years or so, the potency of the Report has arguably shifted away from the public and more towards influencing opinion within the UN’s central policy-making body on the issue of drugs, the Commission on Narcotic Drugs (CND). For this reason, it is vital that the Board presents balanced, accurate and impartial information within its Reports in their entirety, including the thematic chapter.

Since 1992, the first chapter of the Annual Report has, according to a former President and longstanding member of the Board, ‘addressed a specific drug-related theme of international importance’ with the themes ‘chosen each year on the basis that it reflected current concerns related to the conditions prevailing in the world at that time’. It is perhaps no surprise then that within the current international policy environment the focus of this year’s Chapter I is cannabis – more precisely ‘Cannabis and cannabinoids for medical, scientific and “recreational” use: risk and benefits’.

The INCB’s attention to and stance on cannabis, including its use for medical purposes, has fluctuated over the years. Yet today it is faced with an increasingly pressing dual dilemma: how to approach the concomitant expansion of – sometimes poorly controlled – medical markets and the shift by a growing number of jurisdictions to implement legally regulated markets for non-medical and non-scientific cannabis use. This IDPC report aims to provide a critique of the Board’s discussion of cannabis.

IDPC response to the 2017 INCB Annual Report

IDPC response to the 2016 INCB Annual Report

IDPC response to the 2015 INCB Annual Report

IDPC response to the 2014 INCB Annual Report

IDPC response to the 2013 INCB Annual Report

IDPC response to the 2012 INCB Annual Report

IDPC response to the 2011 INCB Annual Report

IDPC response to the 2010 INCB Annual Report

IDPC response to the 2009 INCB Annual Report

IDPC response to the 2008 INCB Annual Report

IDPC response to the 2007 INCB Annual Report

The International Narcotics Control Board on cannabis: A critique of the report for 2018

This report is based on information provided to the EMCDDA by the EU Member States, the candidate country Turkey and Norway in an annual reporting process.

The purpose of the current report is to provide an overview and summary of the European drug situation and responses to it. The statistical data reported here relate to 2017 (or the last year available). Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Although considerable improvements can be noted, both nationally and in respect to what is possible to achieve in a European level analysis, the methodological difficulties in this area must be acknowledged. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Caveats and qualifications relating to the data are to be found in the online version of this report and in the Statistical Bulletin, where detailed information on methodology, qualifications on analysis and comments on the limitations in the information set available can be found. Information is also available there on the methods and data used for European level estimates, where interpolation may be used.

The reference period for all graphics, analysis and data included in this report is the drug situation up to the end of 2018. All grouping, aggregates and labels therefore reflect the situation as it was in 2018 in respect to the composition of the European Union and the countries participating in EMCDDA reporting exercises. Due to the time needed to compile and submit data many of the annual data sets included here are from the reference year January to December 2017.

European Drug Report 2019: Trends and Developments

By Dave Bewley-Taylor and Christopher Hallam

The 62nd session of the Commission on Narcotic Drugs (Commission or CND) and its Ministerial Segment took place in Vienna between 14 and 22 March 2019. Protracted and sometimes conflicted discussions led up to the event, held ten years on from the Political Declaration and Plan of Action of 2009, which had passed with little sign of success. In the words of the 2018 World Drug Report, ‘Both the range of drugs and drug markets are expanding and diversifying as never before’.

The global situation has produced a range of often profoundly different policy responses by member states, which can loosely be characterised as heading in two directions: one dominated by law enforcement measures, the second accepting the reality of the market and seeking to manage its harmful effects. The decision of Canada to introduce a legally regulated market for cannabis has prompted a strident response by the Russian Federation, which repeatedly attacked the Canadian move during the CND. These contrasting views were reflected continually in the country statements of the Ministerial Segment, and in later CND sessions. The Ministerial Declaration itself reiterated some of the themes of the 2016 UNGASS Outcome Document, while reflecting these policy tensions between member states. Amongst the most significant components of the Ministerial Declaration is the apparently unprecedented acknowledgement of the ‘persistent and emerging challenges’ faced by the international drug control regime.

There were eight draft resolutions proposed at the Committee of the Whole (CoW). The most controversial of these, stemming as it did from the tensions surrounding cannabis regulation policy, was that of the Russian Federation, finally entitled ‘Supporting the International Narcotics Control Board in fulfilling its treaty-mandated functions in cooperation with Member States and in collaboration with the Commission on Narcotic Drugs and the World Health Organization’ (Resolution L3). The Russian resolution was intended to support and enhance the role of the INCB in its role of policing compliance with the international drug control conventions, and in particular in responding to cannabis legalisation, which preoccupied Russia throughout the Commission. In the event, the resolution was negotiated through intensive debates at the CoW and in informal meetings, the ultimate version being less strident than the original. Other resolutions, including some important ones on hepatitis C (the very first CND resolution on this topic) and HIV prevention among women who use drugs, are detailed below.

In addition, there were a number of decisions made at the 62nd CND regarding the scheduling of substances under the drug control conventions, with CND members voting on scheduling recommendations from the Expert Committee on Drug Dependence (ECDD; on drugs and medicines) and the International Narcotics Control Board (INCB; on precursors). They included four fentanyls now included under Schedule 1 of the 1961 Single Convention, five synthetic cannabinoids now included under Schedule 2 of the 1971 Psychotropic Convention, and three precursors now included under Table 1 of the 1988 Trafficking Convention. The Commission, however, postponed voting on recommendations made by the ECDD in relation to cannabis.

The CND was marked by vibrant civil society engagement, with almost 500 civil society delegates attending, several countries including civil society representatives on their country delegations, over 40 side events co-organised with civil society organisations, and civil society delegates delivering statements at the plenary. This represents a continued growth of civil society engagement in the Commission’s activities – despite stronger-thanusual tensions with UN building security staff. The now-familiar ‘informal dialogues’ took place, with discussion between civil society and the CND Chair, the Executive Director of the United Nations Office on Drugs and Crime (Office or UNODC) and the President of the INCB.

IDPC report of proceedings: The 2018 Commission on Narcotic Drugs

IDPC report of proceedings: The 2017 Commission on Narcotic Drugs

IDPC report of proceedings: The 2016 Commission on Narcotic Drugs and its special segment on preparations for the UNGASS on the world drug problem

IDPC report of proceedings: The 2015 Commission on Narcotic Drugs and its special segment on preparations for the UNGASS on the world drug problem

IDPC report of proceedings: The 2014 Commission on Narcotic Drugs and its High Level Segment

IDPC report of proceedings: The 2013 Commission on Narcotic Drugs

IDPC report of proceedings: The 2012 Commission on Narcotic Drugs

IDPC report of proceedings: The 2011 Commission on Narcotic Drugs

IDPC report of proceedings: The 2010 Commission on Narcotic Drugs

IDPC report of proceedings: The 2009 Commission on Narcotic Drugs

IDPC report of proceedings: The 2008 Commission on Narcotic Drugs

IDPC report of proceedings: The 2007 Commission on Narcotic Drugs

The 2019 Commission on Narcotic Drugs and its Ministerial Segment: Report of Proceedings

In November 2018, the UN System Chief Executives Board for Coordination (CEB) – the main instrument for supporting and reinforcing the coordinating role of UN intergovernmental bodies on social, economic and related matters – adopted the ‘United Nations system common position supporting the implementation of the international drug control policy through effective inter-agency collaboration’. The OHCHR contributed to drafting the document, and featured it in its 2018 Human Rights Report.

To ensure the implementation of the UN common position, the CEB established the ‘UN system coordination task team on the implementation of the UN system common position on drug-related matters’, led by the United Nations Office on Drugs and Crime (UNODC), within the framework of the UN Secretary General’s Executive Committee. The task team is responsible for translating the common position into practice by guiding approaches across the UN system and stepping up efforts to ensure that no one is left behind; identifying joint inter-agency activities; and speaking with one voice and raising awareness of the multifaceted nature of drug policy.

Both the common position and the task team are critical opportunities to promote more coherence within the UN system both at international and national levels – ensuring that drug policies promoted by the UN are ‘truly balanced, comprehensive, integrated, evidence-based, human rights-based, development-oriented… within the framework of the 2030 Agenda for Sustainable Development’.

  Implementing the UN common position on drug policy: The role of the OHCHR

According to the Inter-American Commission on Human Rights (IACHR), the nonexceptional use of pretrial detention is one of the most serious and widespread criminal justice problems affecting Latin American countries. One out of three people awaiting trial in the Americas, which include Canada and the United Sates, are held behind bars and over the last two decades, the number of pretrial detainees in the region has grown by around 60%.

One of the leading causes of this increase is the excessive use of pretrial detention for drug-related offenses in Latin America. The disproportionate and prolonged use of pretrial detention undermines the principles of the presumption of innocence, legality, necessity and proportionality. It also greatly contributes to prison overcrowding, and frequently exposes detainees to conditions of ill treatment and/or violence. In some countries, women are more likely to be held as pretrial detainees than men, disproportionately impacting these women and their families.

In recent years, some Latin American governments have introduced reforms to reduce the use of pretrial detention. While these reforms are welcome, they have only made a small dent in the problem, and much more can—and should—be done to ensure that pretrial detention is the exception, not the rule.

This report provides the most recent data on the use of pretrial detention, looks specifically at its impact on women, and concludes with a series of recommendations to significantly reduce the number of women in pretrial detention in Latin America.

Pretrial detention in Latin America: The disproportionate impact on women deprived of liberty for drug offenses

By the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)

Available data on the substances injected by users are based on self-reports collected in drug treatment registries or ad-hoc surveys. While these data are informative, they are often available only after some delay and are not analytically confirmed. Moreover, little is known about people who inject drugs that are not reached by drug services. The ESCAPE (European Syringe Collection and Analysis Project Enterprise) project seeks to complement existing data on substances injected by users, by providing timely and local information derived from the analysis of the residual content of used syringes.

A group of European researchers has developed an innovative method to obtain information on injected substances by chemically analysing the residual content of used syringes. For this study, syringes were collected from the bins of street automatic injection kit dispensers and at harm-reduction services in a network of six sentinel European cities: Amsterdam, Budapest, Glasgow, Helsinki, Lausanne and Paris. The contents of 1 521 used syringes were analysed in five laboratories using chromatographic and spectroscopic methods.

Future campaigns will aim at collecting syringes from other settings and will allow the monitoring of trends over time. The network will be expanded to include more cities, in order to provide a more representative picture of the European situation and to advance knowledge on local injecting practices.

Drugs in syringes from six European cities 

This report covers the judicial use of the death penalty for the period January to December 2018. As in previous years, information is collected from a variety of sources, including: official figures; judgments; information from individuals sentenced to death and their families and representatives; reporting by other civil society organizations; and media reports. Amnesty International reports only on executions, death sentences and other aspects of the use of the death penalty, such as commutations and exonerations, where there is reasonable confirmation. In many countries governments do not publish information on their use of the death penalty. In Belarus, China and Viet Nam, data on the use of the death penalty is classified as a state secret. During 2018 little or no information was available on some countries – in particular Laos, North Korea (Democratic People’s Republic of Korea) and Syria – due to restrictive state practice and/or armed conflict. Therefore, with only a few exceptions, Amnesty International’s figures on the use of the death penalty are minimum figures. The true figures are likely to be higher. Where the organization obtains fuller information on a specific country in a given year this is noted in the report. In 2009 Amnesty International stopped publishing its estimated figures on the use of the death penalty in China, a decision that reflected concerns about how the Chinese authorities misrepresented Amnesty International’s numbers. Amnesty International always made clear that the figures it was able to publish on China were significantly lower than the reality, because of the restrictions on access to information. China has yet to publish any figures on the death penalty; however, available information indicates that each year thousands of people are executed and sentenced to death. Amnesty International renews its call on the Chinese authorities to publish information on the use of the death penalty in China.

Amnesty International opposes the death penalty in all cases without exception regardless of the nature or circumstances of the crime; guilt, innocence or other characteristics of the individual; or the method used by the state to carry out the execution. The organization campaigns for total abolition of capital punishment.

Death sentences and executions 2018 

The East African Community is a regional intergovernmental organization established by a Treaty of 1999, is made up of six (6) Partner States namely: The Republics of Burundi, Kenya, Rwanda, South Sudan, Uganda and the United Republic of Tanzania with its headquarters in Arusha, United Republic of Tanzania - mainland. The EAC has an estimated population of over 150 million people. The region is mainly composed of a young population with up to 64.2% aged 0-24 years1 . The objectives of the EAC are to develop policies and programs for widening and deepening cooperation among the Partner States in political, economic, social and cultural fields, research and technology, security, legal and judicial affairs for their mutual benefit. In line with the Vision of the EAC Health Policy “A healthy and productive population in the East African Community” the region has prioritized health as one of the pillars essential for the attainment of the above objectives. With the coming into force of the EAC Common Market Protocol ratified by all Partner States there is increased movement of people goods and services across the region. The increased volume of people crossing from one partner state to another is likely to facilitate the movement of licit and illicit Alcohol, drugs and other substances. This is further compounded by the existence of porous borders across Partner States, nonadherence to existing regulatory mechanisms and inadequate human capacities.

East African Community regional policy on prevention, management and control of alcohol, drugs and other substance use

By Knowmad Institut, FAAAT, Kenzi Riboulet-Zemouli, Simon Anderfuhren-Biget Ph.D, Martin Díaz Velásquez and Michael Krawitz.

Due to its characteristics, widespread cultivation and use, and diversity of its applications the Cannabis sativa L. plant directly pertains to at least 62 of the 169 targets found in 15 out of the 17 Sustainable Development Goals (SDGs). Surprisingly, this plant affects the SDGs both positively and negatively.

This report explains how the “hemp-issues” of Cannabis sativa L. (non psychoactivity-related uses) can contribute to meeting Goals 1, 2, 7, 9, 11, 12, 13 and 15, but also why reforming the current repressive, prohibitive, and marginalizing policies relating to “marijuana-issues” (psychoactivity-related uses of Cannabis sativa L.) is indispensable to meet Goals 3, 4, 5, 8, 10, 13, 16 and 17.

The Cannabis plant has accompanied humankind for millenia. It has provided food and numerous products derived from its fiber (various locally sourced and produced-materials). More recently, the plant has been explored for the soil-cleaning property of its roots and the significant biomass produced by the stems of the plant, a promising source of energy, a great building material and recyclable vegetative plastic. The plant has also been employed in all continents and throughout human history for use in medicine, spiritual ritual and recreation.

Current overly restrictive public policies addressing the psychoactive uses of the plant hinder the availability of the plant and its derivatives for medical purposes and prevent implementation of sound and sensible regulatory access frameworks. Repressive and authoritarian drug-control policies foster corruption, increase imprisonment rates, augment adverse social and health outcomes for people who use cannabis and generate innumerable human rights violations in particular among women, minorities, low income communities and indigenous peoples.

Reaching the Goals of the 2030 Agenda means adopting significantly different regulations to all aspects and activities linked to the uses of the Cannabis plant, moving away from the artificial separation between “hemp” and “marijuana”. Scientists talk about Cannabis, farmers talk about hemp, politicians talk about marijuana, but none of them really get a clear picture of the ethnobotanical context of this plant. It is time for us all to get on the same page.

Cannabis & sustainable development

How is cannabis use controlled in the legal systems in the Nordic countries? How do the Nordic legal systems see cannabis as a drug, and how does this affect the cannabis user? The Nordic Welfare Centre´s new report Cannabis policy and legislation in the Nordic countries looks at the similarities and differences in legislation and the ways in which the law is enacted in legal practice, police work, and other arenas.

After alcohol, cannabis is the second most common intoxicant in the Nordics and cannabis use is increasing among young adults in most Nordic countries. It is therefore not insignificant how society views cannabis use: is it a social problem, a health problem, or a problem of law and order? The answer matters a great deal to the user. Increasing use will put pressure on the societal responses although the majority of cannabis users are not problem users in need of treatment.

The Nordic countries rely on a restrictive approach in their cannabis control. All countries, except for Denmark, are influenced by the vision of the drug-free society where the justice system is seen as the main actor in solving the drug problem. The majority of all cannabis crimes in the Nordic countries have to do with use and/or possession for personal use. The proportion has varied over the decades depending on enforcement priorities.

Cannabis policy and legislation in the Nordic countries

By Bruce Walace, Flora Pagan and Bernadette Pauly

Drug-related overdoses were declared a public health emergency in British Columbia, Canada in April, 2016 facilitating the scale-up of responses including rapid sanctioning and implementation of overdose prevention sites (OPSs). OPSs are a health service providing supervised injection and immediate overdose response. In BC, OPSs were operational within weeks of sanctioning. In the first year of operation over 20 OPSs were established with approximately 550,000 visits and no overdose deaths at any site. In this paper, we examine the implementation of OPSs as a novel and nimble response to prevent overdose deaths as a result of injection drug use.

A multiple case study design was used with the Consolidated Framework for Implementation (CFIR) informing the analysis. Three sites in a single city were included with each site constituting a case. In this paper, we focus on qualitative interviews with 15 staff and their perceptions of the implementation of the OPSs as well as provincial and local documents.

The legislative process to implement OPSs was unprecedented as it sanctioned supervised injection services as an extraordinary measure under a declared public health emergency. Innovative and inclusionary practices were possible within state-sanctioned OPSs, as the sites were government-directed yet community-developed, with PWUD centred in service design, implementation and delivery. OPSs lack permanency and may be limited to the duration of the public health emergency.

The rapid implementation of OPSs provides an international example of an alternative to lengthy and often onerous sanctioning processes for supervised consumption services (SCSs). Overdose prevention sites provide an example of a novel service design and nimble implementation process that combines the benefits of state-sanctioned injection services with community-driven implementation. Such evidence questions the continued acceptability of governments’ restrictive sanctioning processes, which have limited expansion of SCSs internationally and the implementation of services that are not necessarily aligned with the needs of PWUD.

Publications