For many years under the Berlusconi government, Italian drug policy has been directed by ideology. The government passed a legislative amendment to increase penalties for all categories of drug possession and use, treating cannabis with the same severity as heroin and cocaine. It has also been consistently hostile towards harm reduction services in domestic and international drug policy forums. However the departure of the minister primarily responsible for spearheading ‘tough on drugs’ policies hopefully heralds a corresponding change in Italy’s approach to drugs. It was in this promising context that a group of judges, magistrates, politicians, NGOs and academics met to discuss the problems they are inheriting from the outgoing administration, and the emerging opportunities for reform.

We met last week on 23 – 25 February 2012 in Syracuse, Sicily at an international expert seminar co-convened by the International Drug Policy Consortium, Societa della Ragione, and Forum Droghe. Our discussions focused on two key themes: decriminalization and diversion schemes, and harm reduction. We heard from experts on the experiences and lessons learned by countries in Europe, Asia and South America, in order to get a sense of the challenges to tackle and opportunities to grasp in implementing decriminalization, diversion and harm reduction measures. Experts from the UN and academia also shared advice on ensuring effective harm reduction interventions and cultivating supportive environments to sustain those interventions, especially building a positive relationship between law enforcement and people who use drugs.

We all shared a hope that Italy could gradually overcome significant barriers to its implementation of decriminalization, effective diversion and up-scaled harm reduction measures: rising rates of prosecution of drug offences (due partly to inconsistent prosecution practices), and declining investment in needle exchange schemes and opiate substitution treatment. Overcoming these barriers will only be possible with continuing open debate, informed by evidence and international best practice, and increasing investment in the reforms that are appropriate for Italy.

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A promising time to open debate on reform in Italy

Last week in Bangkok (6th to 8th February 2012), delegates from governments, UN agencies and civil society organisations (CSOs) based in the Asia-Pacific region gathered in the UN Conference Centre to discuss the progress they have made in taking action on problems related to HIV/AIDS. But it is perhaps fair to say that for some countries, the preference was to not discuss the progress made (suggesting that there was no real progress) but to simply deliver prepared statements on aspects of their country’s national policies that revealed little about the reality for people living with HIV/AIDS (PLWHIV). Procedure was followed but substance was disappointingly lacking.

After the two and a half day meeting, and significant organisational efforts by the UN, country representatives and CSO delegates, it is reasonable to expect that a good understanding of the progress made and ongoing challenges for governments could be achieved. There were certainly moments that met this expectation. China spoke about the challenge of implementing methadone maintenance treatment and needle/syringe exchange programmes because of resistance from law enforcement agencies and conflicts between laws that are yet to be resolved. Tajikistan reported that their main challenge at the moment is to change social attitudes, where it is commonly believed that HIV is a Western disease that did not affect Muslims. The CSO representative in the Vietnamese delegation talked of the need to build the capacity of CSOs, especially those that are willing to be critical of responses to HIV/AIDS-related problems. But I thought these moments were too few and far between.

In spite of the shortfall in meaningful discussion on progress and challenges, we should not neglect some of the positive features of this UN meeting. Such as the fact that this was the first time that CSOs could participate, and not only observe, a UNESCAP meeting. ‘Participate’ in the UN sense, meaning that a CSO could only attend by invitation (given in accordance with strict criteria), make statements during formal plenary sessions (if representing a CSO with ECOSOC status, and at the discretion of the Chair) and provide comments during the interactive session.

I was therefore delighted and grateful that I could deliver a statement on behalf of IDPC. But you might ask: why ‘grateful’ when CSOs have the right to participate (even if only in the UN sense)? In short, it is because the UN system’s focus on procedure over substance makes it incredibly difficult for CSOs to participate in a meaningful way. There is certainly value in UN activities such as this UNESCAP meeting, yet I can’t help thinking that there is potential for these forums to be so much more effective, impactful and inclusive.

Procedure over substance: progress towards the MDGS on HIV in Asia Pacific

Everyone in the drug policy movement is saying that a corner has been turned, and significant reform is now inevitable. As ever, it is more complex than that, as governments and advocates around the world grapple with the new uncertainties.

Looking back over the last 10 years or so, I see some real change, but also some surprising inertia, and what comes next is by no means certain. When I went to work at the UNODC in 2002, it was indeed heresy to acknowledge that the international drug control conventions were not successfully controlling the drug problem, and saying you promoted harm reduction was career suicide (as it happens, I was forced to resign in 2003 for saying both those things – although maybe also for being too involved with George Soros and OSI).

Nearly ten years later, there is a mixed picture of progress and increased sophistication in the UNODC message: On the ‘failed drug war’, successive leaders have acknowledged the limited progress (now talking about containment of a problem, rather than a drug free world), and openly talk about the ‘unintended’ negative consequences of a system built on prohibition and punishment. But the UN institutions, particularly the INCB, continue to strongly defend the current policy framework as the best way to maximise human health and welfare. The vehemence of the INCB response to the Bolivian government’s reasonable proposal for amendments to the references to coca leaf in the 1961 Convention attests to their continued faith in repression and condemnation as the best instruments of drug control, and their fear of any alternative approach that ‘undermines the spirit of the Conventions’.

On harm reduction, despite massive increases in research and practical experience, policy progress is incredibly slow. The international community can still not agree to use the words ‘harm reduction’ in official Vienna documents - in a Kafka-esque twist, the interventions are recognised, but they have to be referred to as ‘public health measures’, or ‘reducing negative health consequences’. It is amazing that in 2011, when the evidence is unequivocal and the rest of the UN happily promotes harm reduction, gatherings of diplomats and experts in Vienna still have to perform these verbal gymnastics.

On the wider policy front, it is true that the voices calling for proper review and reform of drug strategies are getting louder and more influential – the recent Global Commission on Drug Policy report being the latest example. But are governments making any significant moves? I am not seeing it. Some, like the Czech Republic, Argentina, and Portugal are comfortably in a liberalising phase and, while there is still much to worry about in the US strategy under Obama, there is no doubt that the rhetoric has changed. On the other hand, some European countries are pulling back from some of the health-based initiatives pursued previously, and many African and Asian governments are still enthusiastically passing tough drug laws, and strategies of zero tolerance.

The network that I currently Chair (IDPC) tracks and analyses these ebbs and flows of policy developments to seek ways to positively influence the debate and push for humane, effective and evidence-based drug control. I hope that you enjoy reading our blog posts and we look forward to reading your responses and comments.

The times they are a’changing? 

Drug policy is too often abstract. Government policy makers and Vienna-based diplomats spend much of their time debating drug law ideology, while forgetting the realities of people badly hurt by the laws and policies they create. That's why IDPC, in collaboration with Talking Drugs, initiated a series of magazines which feature personal stories behind the policy debates to give a flavour of how policies affect the real, lived experiences of people on the ground.

The stories told in the inaugural IDPC magazine are a stark reminder of why the drug laws of many countries across the globe need to be fixed. Each story tells us of the disproportionate harm suffered by individuals, of the badly focused resources targeting low-level “offending”, and of the human rights abuses inflicted in the name of drug control.

The consequences of a zero tolerance approach to drugs have often been more harmful than drug use itself, with overly punitive drug laws contributing to serious violations of human rights. Shifting resources towards prevention, treatment and harm reduction is more effective in reducing drug related harms than relying solely on the criminal justice system.

Such a rebalancing also frees up law enforcement, courts and prisons to focus on more serious crime such as large scale drug trafficking, while removing barriers for dependent drug users to access treatment. Recent advances in research around drug dependency support the notion that drug use should be viewed through a health and social policy lens instead of a criminal justice one. In recent years, several countries have sought to adopt more humane, evidence-based and public health focused drug law. The Netherlands and Portugal are among the few countries that have created drug laws which are ‘fit for purpose’.

My country, New Zealand, has an opportunity to create healthier drug law. Our obsolete, 35-year-old Misuse of Drugs Act is undergoing a “first principles” review conducted by the Law Commission, our government’s independent legal brains-trust.

In their review, launched last month, the Commission gave this blunt yet accurate assessment of our drug law: it “no longer provides a coherent and effective legislative framework for responding to the misuse of psychoactive drugs… The Act is now outdated and does not reflect current knowledge and understanding about drug use and related health, social and economic harms.” The same can be said for most drug laws around the world.

I won’t detail the Commission’s well considered law reform options here, but I do recommend that you follow what is happening in New Zealand. In the meantime, reflect on the stories that follow, and remind yourself of the pain that inhumane and harmful drug policies and laws cause to so many people around the world.

Talking about human rights violations in the name of drug control – IDPC/Talking Drugs Magazine, 1

Over the past decades, there has been much discussion about the effectiveness of several aspects of the drug control system. The police play a decisive role in enforcing drug laws, and directly experience the effects caused by the implementation of several provisions that aim to reduce drug use in our society. Therefore, although it is not the task of the police to design policy strategies and decide priorities in action plans, it is crucial to listen to their experiences. The police should systematically be asked to comment on proposed drug policies and make suggestions to improve current practice.

The second edition of the IDPC magazine features interviews with police officers from South East Europe and Eurasia – namely Albania, Greece, the Kyrgyz Republic, Serbia and Ukraine. The police officers are asked to express their views on their countries’ law enforcement strategies, which in these two regions often tend to focus on arresting drug users for possession of small amounts of illegal substances.

In South East Europe and Eurasia, as in other parts of the world, there is currently much discussion on the effects of repressive measures towards drug users. The prevailing view remains that punishment, deterrence and fear of social stigma can effectively prevent drug use.

Enabling an open and public debate that questions this attitude is not common practice in most countries in the region; while the countries that experienced a political transition in the 1990s are still seeking to achieve a balance between following the mentality of repressive regimes and tackling the new challenges of freedom and democracy.

It is encouraging that some police officers are open to discussing this issue, although this magazine clearly highlights that many countries are still closed to the idea of an open debate on drug policy issues. There is a need for a systematic approach in the drug policy debate, and there are many obstacles yet to be overcome. The experience in the Kyrgyz Republic shows that, after a long time of advocacy and education, a change in attitude is possible. This political commitment is indispensable for the implementation of new ways to approach the issue of drug use.

IDPC member organisations are aware of the opportunities that can be created for drug users through better understanding and cooperation between health and social service providers and law enforcement agencies. At a regional meeting in Athens in March 2010, NGOs from eight Eastern European countries decided to establish a regional network to strengthen their relationships, create opportunities for mutual cooperation, exchange best practice and improve their contacts with national and regional authorities. One of the main items of discussion was the necessity to develop a new law enforcement strategy. It was recommended to refocus law enforcement objectives in this area, and commit to increased partnerships between health and social care agencies.

The main concern of the parties who signed the 1961 Single Convention on Narcotic Drugs was the ‘health and welfare of mankind’. The question is whether law enforcement practice in the past decades concerning possession of drugs for personal use has been the most appropriate means of protecting our public health and welfare.

The voices of social and healthcare workers, but also – as shown by this magazine – of many law enforcement officials, now clearly indicate that repression and the punishment and imprisonment of drug users are not the appropriate answers to drug use and dependence.

Drug law reform on this issue is gradually gaining ground all over the world. It is the only way to meet the main concern of the 1961 Single Convention, namely to protect the health and welfare of mankind.

Law enforcement officers talking about drugs in South East Europe and Eurasia

The primary producers and consumers of illicit drugs – drug users and farmers of opium, coca and cannabis – are often some of the most marginalised groups in our societies. This is true in both high and low income countries, although the alleviation of poverty is at the heart of what the Millennium Development Goals were set out to achieve.

Crop eradication affects some of the poorest rural communities in Asia and Latin America and reinforces cycles of poverty and violence. This damages the relationships between farmers’ communities and the government, making interventions to support their economic and social development more difficult.

The criminalisation of people who use drugs limits access to harm reduction and treatment and ties up resources that could be better directed at health and social services and education and law enforcement activities aimed at the more powerful actors in the drug trade. The criminalisation of drug using mothers during pregnancy is particularly pernicious and impacts negatively on their health and that of their children, who can face limited access to education, good nutrition and a stable family life.

The third edition of the IDPC Magazine, produced in collaboration with Talking Drugs, focuses on each Millennium Development Goal to illustrate, through testimonies and lived experiences, the severe negative consequences of drug control on development efforts both in developing and developed countries. In this Magazine, we conclude that drug policy choices can make a significant difference on the development agenda at the national, regional and international level.

Blog

A promising time to open debate on reform in Italy

Procedure over substance: progress towards the MDGS on HIV in Asia Pacific

The times they are a’changing?

Talking about human rights violations in the name of drug control – IDPC/Talking Drugs Magazine, 1

Law enforcement officers talking about drugs in South East Europe and Eurasia

Drugs and development, making a positive choice