The International Network of People who use Drugs, along with 188 drug user organisations and working at the national, regional and international level on issues related to drug use, drug treatment, harm reduction and drug policies urge the WHO and the UNODC to revise their guidelines on International Standards for the Treatment of Drug Use Disorders. In brief:
- The paper contains many assertions not supported evidentiarily or cited.
- The phrase ‘harm reduction’ is entirely missing from the document.
- The paper contains crude generalisations and many stigmatising and pathologising assertions.
- Notably, the paper contains numerous implications that people who use drugs and have drug dependencies are dangerous; cannot exercise agency and self-determination; are sick; are unreliable; are bad family members; are bad employees. Needless to say, such crude generalisations are deeply stigmatising and offensive, not to mention unempirical.
- The paper fails to identify criminalisation and prohibition as being responsible for driving much drug related harm and harm associated with drug dependency; instead, it myopically asserts that because drugs are harmful, they are criminalised, without noting that it is due to the fact that they are criminalised that they are so harmful.
- The paper’s active promotion Naltrexone is very concerning, given its lack of evidentiary support: Naltrexone is promoted in the document as of equal value to interventions that are (in contrast to Naltrexone) empirically justified and greatly beneficial; this is arguably used to eclipse interventions with proven efficacy, such as methadone, buprenorphine, and diamorphine/morphine prescribing, due to the document’s clear advocation of abstinence-based recovery.
The guidelines in their current form are not aligned with current UN guidance on harm reduction, nor grounded in evidence. We are concerned that the treatment guidelines in their current state will promote stigma and discrimination against people who use drugs. We call on the WHO and the UNODC to postpone the release or future dissemination of the document until these shortcomings are appropriately addressed. For the full open letter, follow the below link...