At a regular ‘drug policy watch’ meeting organised by Thai CSOs in April, attended also by IDPC and the Law Reform Commission of Thailand (LRCT), I reported on some of the key outcomes of the UN Commission on Narcotics Drugs held in March (CND). None of the Thai CSOs, including IDPC member the 12D Network, had attended and it seemed relevant to share with them our perspective on Thailand’s role in the global drug policymaking body, especially their priorities and position on key topics such as the death penalty, controls on ketamine and civil society engagement.

We had met with members of Thailand’s delegation at CND and noted their statements during the plenary and roundtable sessions, particularly the fact that Thailand remained neutral on whether to call for abolition of the death penalty for drug offences, and sponsoring of resolutions on controls over ketamine, the new MOU between countries in the Greater Mekong Subregion, the UN Guiding Principles on Alternative Development, and drug use prevention. For a record of these statements, please refer to our blog on statements made during CND: www.cndblog.org.

In response, the CSO representatives at the Thailand drug policy watch meeting asked IDPC and the LRCT to co-organise a dialogue involving Thai delegates to the CND and Thai CSOs. They were keen to hear more from Thailand’s delegates on the outcomes of CND and the implications for Thailand. To prepare for the meeting, IDPC drafted a briefing paper on the role and function of CND, key outcomes of CND 2014 relevant to Thailand, and suggested discussion points to help prepare for CSO engagement in CND 2015 (prospects for civil society participation, and open and objective drug policy debate, especially in preparing for the 2016 UN General Assembly Special Session on the world drug problem).

At the meeting, Thailand’s drug control agency (ONCB) presented their priority issues (decriminalisation of kratom and other drugs, alternatives to prison, death penalty, harm reduction, drug use prevention based on scientific evidence, controls on new psychoactive substances and CSO participation) and key engagements (resolutions on the new MOU with Greater Mekong Subregion countries and using sport to prevent drug use, and meetings with countries such as Colombia on alternative development and organisations such as the Colombo Plan about training on drug treatment) at CND 2014.

Other delegates from other ministries such as health raised the possibility of amending Thailand’s approach to drug treatment in response to international criticism about the use of the criminal justice process to assess drug dependence and treatment needs which provoked a lively debate between government representatives.

Representatives from quasi-governmental organisations working on drugs called for a more open, objective drug policy dialogue on alternative options, including decriminalisation, reducing harsh sentences for drug offences and involving people who use drugs in making drug laws and policies, reiterating the need for change from drug policy approaches that have repeatedly proven to be ineffective. CSO representatives focussed on calling for the government’s support for civil society engagement in CND processes.

The ONCB seemed reluctant to welcome the engagement of Thai CSOs. However as chair of the meeting, the LRCT urged the ONCB to work to find ways of enhancing civil society engagement and promised to help maintain the momentum of drug policy dialogue in Thailand. Though now under military control, it is hoped that some space for open, inclusive drug policy debate can be sustained, especially as Thailand is likely to chair the next CND in 2015, a key moment in preparations for UNGASS 2016.

Promise of civil society engagement from Thailand in global drug policy debates

At its recent session, the International Narcotic Control Board elected a new bureau and new President. This signals a farewell to Mr Raymond Yans, who served as the INCB’s last President. While the organisation is generally viewed as a highly conservative one, strongly opposed to reform and apparently viewing the international drug control conventions as eternal Truths carved in stone, the Presidency of Raymond Yans was a particularly controversial one. His interpersonal manner was often considerably less than diplomatic, referring to the elected government of Uruguay as 'pirates'. He was consistent in his resistance to the place of human rights in drug control, and openly hostile to those elements of civil society whose views he did not share. Amongst those who believe that some level of reform is necessary if the drug control system is to engage the realities of drug consumption in the globalised world of the twenty-first century, it is fair to say that Mr Yans will probably not be missed.

His successor is Mr Lochan Naidoo, a Family Practitioner from Durban, South Africa, who is something of an unknown quantity for civil society. On the positive side, Mr Naidoo immediately took the opportunity to state his passionate commitment to ensuring that adequate access to essential medicines is achieved. On the negative, he is rumoured to share many of Raymond Yans’ attitudes and beliefs. At IDPC, we hope that it will be possible to achieve a more productive and mutually respectful relationship with the new President, and welcome him to his post at the critical juncture for international drug policy.

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

Farewell Mr Yans

Speech by Yury Fedotov, Director General/Executive Director, UNODC

Mr. President,
Members of the Board,
Ladies and gentlemen,

Allow me to begin by congratulating President Naidoo on his election, and to say thank you to President Raymond Yans for his hard work and dedication.

I look forward to continuing our work together, particularly in this important period following the High-Level Review of the CND and leading to the UNGASS on the world drug problem in 2016.

As you may know, the 2014 World Drug Report will be launched on 26 June in Vienna at a special event of the CND.

The report devotes a thematic chapter to the control of precursors. My thanks to the INCB Secretariat for the good cooperation in this area.

This chapter notes the success of improved monitoring, strengthened international cooperation and joint actions, often undertaken under the auspices of the INCB.

It also highlights the vulnerabilities leading to diversion, stemming from a globalized trade involving the use of ever-more intermediaries and brokers in the supply chain.

There are instruments available at the international level to deal with these challenges. But they have yet to be effectively used in a number of countries, and their universal implementation would be an important step forward.

The report also addresses the new regulatory frameworks in the States of Colorado and Washington, and in Uruguay.

While it may still take some time to evaluate the overall impact of these changes, based on existing research it appears likely that, with declining risk perceptions and increased availability, use may increase. We will continue to follow developments closely.

Additional challenges identified in the report include the continued increase in the production of amphetamine-type stimulants, and a strong rise in the production of NPS.

Furthermore, there remain serious gaps in service provision, with only one in six problem drug users having access to or having received drug dependence treatment services.

Every year, up to 200,000 people die as a result of drug abuse, mostly as a result of overdose - a preventable condition if adequate measures are in place.

Moreover, 13% of the total number of people who inject drugs are living with HIV, and 52% are living with hepatitis C.

The new set of data on access to services for prevention, treatment and care of HIV presented in this year's World Drug Report can support Member States in addressing this crucial area more effectively.

As we saw at the recent High-Level Review, there is broad understanding and agreement among Member States on the importance of evidence-based, health-centred approaches to address the world drug problem.

I particularly welcome the clear recognition of the value of science in these efforts.

The Scientific Consultation organized by UNODC during the High-Level Review helped to further strengthen links with the academic community, and we are considering ways to maintain this engagement on a regular basis.

The UNODC model law is also being revised to better reflect the health and human rights-centred approach to drug control, and we hope to conclude this process by October.

This action follows a CND resolution requesting UNODC to carry out a review of the drug control model provisions in consultation with the INCB and WHO, in particular with the aim of improving access to controlled medication.

The review covers several issues that are directly related to the mandate of the INCB, and we look forward to receiving your feedback on the current text.

At the same time, UNODC is continuing its efforts to enhance regional and inter-regional coordination to pursue and dismantle drug trafficking networks.

Our new "networking the networks" initiative aims at promoting closer cooperation between existing law enforcement coordination centres and platforms to help leverage their combined strength.

The Joint Ministerial Statement resulting from the High Level Review reaffirmed the international drug conventions as the health and human rights-centred cornerstone of the drug control system.

I think we can all agree that this provides a strong basis for the continued dialogue on global drug policy as we head towards the 2016 UNGASS.

The CND at its 57th session adopted by consensus a resolution entitled "Special session of the General Assembly on the world drug problem to be held in 2016", which paves the way for the UNGASS preparations, and specifies the leading role to be played by the CND.

The Commission, under its chair, Ambassador Shamaa, has immediately started implementation of the resolution, in particular through the initiation of a broad process of consultation with all stakeholders.

A new website, ungass2016.org, has also been created to support this.

INCB has been invited to actively participate, and I am looking forward to receiving the contribution of the Board to this very important process.

Thank you for your attention, I wish you a productive session.

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

Assessment of the drug control situation by UNODC 110th session of the INCB

At its 110th session INCB will examine overall treaty compliance by selected countries; the supply of opiate raw materials and demand for opiates for medical and scientific purposes; as well as new psychoactive substances.

VIENNA, 19 May (UN Information Service) - The new President of the International Narcotics Control Board (INCB), Lochan Naidoo of South Africa, said today he was passionate about ensuring adequate prevention and treatment of addiction and the availability of internationally controlled medicines for pain treatment and for treating mental and neurological illness.

Mr. Naidoo was elected today, in accordance with the Board's rules of procedure and practice, at the Board's 110th session that is taking place in Vienna from 19 to 30 May. The INCB also elected the members of its Bureau. The new President underscored his commitment to fulfilling the INCB mandate of promoting and monitoring the implementation of the international drug control treaties, which, he noted, "is all the more challenging at a time of increased debate at the national and regional levels on drug policy, and as the international community prepares for the 2016 General Assembly Special Session on the world drug problem". "I am passionate about ensuring adequate prevention and treatment of addiction and the availability of internationally controlled medicines for pain treatment and for the treatment of mental and neurological illness worldwide," he said.

The International Narcotics Control Board elects new President and Bureau

An event organised last week by the Criminal Justice Centre, School of Law, QMUL and DrugScience titled “New Psychoactive Substances (NPS): Science, Law and Policy” offered in-depth discussions of NPS by bringing together academics and practitioners from various backgrounds including science, health, law, market involvement, and drug policy advocacy.

NPS can pose serious harms to health. For researchers working in the field of NPS, the limited accessibility to usage information poses a great difficulty.

Dr John Ramsey explained that there are several traditional approaches to discern which NPS are being used, but each of them has serious shortcomings in terms of accuracy and completeness. Relying on self-reporting, questionnaires, and website monitoring is insufficient since users often do not know the specific compound they are taking. Similarly, police reports and hospital admission staff often fail to accurately record the consumed substances reported, making this data source unreliable. Death reports produced by coroners are also insufficient, partly because the role of the coroner is to exclude the possibility of crime rather than accurately report the cause of death, and also because the coroner’s report can take up to a year after the death has occurred, a delay unsuitable for responding to the ever-changing NPS market.

So how are researchers gathering reliable data on NPS? By collecting samples from wastewater (sewage) and pooled urine! There are, of course, limitations to these sources as well. The former can only provide information on commonly consumed substances, as there has to be a high level of drug use for it to be detectable in wastewater. Pooled urine collection allows detection of substances that would not arise in wastewater analysis; however, as one can imagine, the collections are primarily from male subjects.

Drug checking services were not discussed during the event, likely because the speaker was focusing on methods currently used in the UK. However, it is worth highlighting drug checking as a very successful initiative that allows people who use drugs to know which specific compounds they are taking, and therefore improves public health while also gathering critical data on what drugs are being bought, sold, and consumed. Such a scheme would increase researcher accessibility to information about NPS usage in the UK, and would empower people who use drugs to make informed decisions about their use.

Many believe that there are no laws regulating the sale and use of NPS. However, there are several cases in which some “legal” highs may in fact be illegal. In order to develop a sensible legal scheme to deal with NPS, Professor Rudi Fortson QC explained that we must be aware of existing laws.

In the UK, there have been court cases in which NPS were prosecuted through the Misuse of Drugs Act. One such case found that some of the batches created by a chemist and intended to be NPS in fact produced substances banned under the Misuse of Drugs Act. Another case featured a chemist that, while producing NPS, had to go through various banned chemical compound structures.

NPS can also fall under the “medicines” legislation, which covers 1) any substance 

 as having properties of preventing or treating disease in human beings; or 2) any substance that may be used by or administered to human beings with 

 restore, correct, or modify a psychological function. The first part of the definition explains why retailers present NPS as “bath salts” or “plant food”. The second part means that a product can be considered medicinal even if it has no medicinal value. Since the sale and consumption of unauthorised medicinal products is not permitted by law, if NPS are treated as medicinal products, their sale and consumption can be considered illegal.

Several other regulations can be used to prosecute the sale of NPS in the UK, many of which involve packaging deception (although the average consumer taking NPS usually intends to do so and is thus generally not deceived by the packaging). This was illustrated in Belfast, where the General Product Safety Regulations (which essentially ensures that no manufacturer puts unsafe products on the market) have been employed to discontinue the sale of NPS by all but one retailer – and this last retailer is on its way to court.

For retailers, the limitations on product safety labelling mean that they have to rely on users doing their research and using common sense. There are, however, several voluntary actions taken by in-store retailers to enhance NPS safety, including: lab testing, human testing (retailers and customer groups), single dose packaging, minimum age of 18 (verified via social media checks), refusing sale of excessive quantity, and daily monitoring of the internet for policy changes and other information.

Despite these precautions, within the current legal regulations, retailers are stuck between a rock and a hard place. On the one hand, they cannot present NPS as being for human consumption (and therefore provide all the necessary safety information) because the products may then be considered medicinal. On the other hand, they cannot simply label their products as “plant food” as they will then be violating several packaging deception laws, such as the General Product Safety Regulations. The laws must be revised to reflect a pragmatic solution to NPS that recognizes the existing demand for substances and prioritizes public health.

Conference attendees supported the legal actions taken in Belfast, as most believed that the use of existing legislation should be fully employed before the creation of any new law. Attendees agreed that a blanket ban on the sale of NPS until substances could be adequately tested and proven to pose low harm for human consumption was an appropriate strategy moving forward. However, previous experiences have shown that the banning of all substances is often accompanied with the emergence of their sale on the black market to meet demand, both online and offline. For consumers, this means having access to even less information about what they are purchasing – often resulting in greater levels of harms. Shutting down NPS retailers therefore does not equate to shutting down NPS sales. It is important to move harmful substances out of the marketplace, but without giving consumers viable alternatives, many will turn to the black market. This is what New Zealand has tried to do with their NPS legislation, which will enable the least harmful substances to be sold to meet demand. Such a regulatory framework should be considered in the UK.

This event was the first in a series of conferences exploring the future of pharmacological regulation. Look out for future events by following @Drug_Science, visiting http://www.drugscience.org.uk/, and keeping an eye on the IDPC events page.

All about NPS – Different sectors come together to learn about “legal” highs

By Farah Diaz-Tello, National Advocates for Pregnant Women (USA) and Sebastian Saville, International Doctors for Healthier Drug Policies

This week, despite an extremely inclusive and far-reaching campaign of multiple agencies both in US and internationally, US state Tennessee passed a law that permits assault charges for women who engage in any ‘unlawful’ act that may result in adverse pregnancy outcomes. Much attention has been on how it will be used to punish women addicted to drugs even though this is against advice and evidence from international medical and public health experts. However, while receiving less publicity, of even more concern is the huge discretion given to prosecutors in the application of the law. Depending on the prosecutor, for the same offence, a woman may be charged with a misdemeanor and diverted to a drug court program or instead charged with aggravated assault and sentenced to 15 years in prison.

It is fair to assume that African-American women, because they are most susceptible to poorer pregnancy outcomes regardless of drug use or socioeconomic status, will be punished most severely.

Cherisse A. Scott, founder and CEO of SisterReach, an advocacy organization focusing on African-American women, said in a statement, “This law separates mothers from their children and is not patient-centered. Tennessee families who are already being hit the hardest by policies such as the failure to expand Medicaid, poverty and a lack of available drug treatment facilities will be most deeply impacted by this bill. Mothers struggling with drug addiction in Shelby County, rural communities throughout Tennessee and poor mothers and their families will be the ones who suffer the effects of this dangerous legislation the most.”

Journal of Health Politics, Policy, and Law

 shows that these concerns are well founded. Documenting 413 cases of arrests, detentions, and forced medical interventions upon pregnant women, the study found that when laws intended to protect women are used against them, the ones who suffer most are low-income, African American women in the US South.

The impact of this law will be felt by women more broadly: the study’s authors conclude that laws and policies that make women criminally accountable for pregnancy outcomes are part of a larger effort to establish that women should have a separate and unequal set of legal rights than others. Tennessee’s new law addresses a health concern as a matter for criminalization but even worse, it treats pregnant women as a population who can be singled out for special control and surveillance by the state.

Although extremely disappointed that the Governor of Tennessee chose not to veto the law, International Doctors for Healthier Drug Policies (IDHDP) will continue to challenge this law and to support health-based policies to replace those that seek to punish already marginalized populations.

IDHDP and National Advocates for Pregnant Women (NAPW USA) ask for your support to continue the challenge of this law, to challenge the arrests that have already happened and will continue to happen, and to build on the coalition led by reproductive justice organizations, including NAPW, SisterReach, Healthy and Free Tennessee, Young Women United, SisterSong, with the powerful support of 

, to expose the appalling harm this law will do.

Keep up-to-date with drug policy developments by subscribing to the 

Unhealthy laws in need of emergency response: Tennessee criminalises pregnant women who use drugs

New Zealand took a step backwards Sunday night with proposed changes to their New Psychoactive Substances (NPS) legislation.

Last year, the Psychoactive Substances Act was introduced. This piece of legislation regulates the sale, manufacture, and importation of New Psychoactive Substances (NPS) or drugs commonly referred to as ‘legal highs.’ After numerous attempts to simply ban legal highs, only to see them quickly replaced by new substances, the New Zealand government decided to take a new approach. The Act turned the tables, placing the onus of proof onto manufactures to prove the substances are ‘low risk’ before they can be sold.

While the bill was going through Parliament, the select committee decided that an interim period was needed between the Act coming into force and the introduction of regulations and rules around a clinical testing regime. The rationale behind this was to prevent people (particularly those who were dependent on these products) from turning to the black market and to ensure manufacturers had faith in the system. Once the Act was passed, products which appeared to be the least harmful were given temporary licenses and could still be sold until the testing process was in place.

Forty-seven products were initially granted temporary licenses. The Act provided the government with the power to instantly remove products from sale should they prove to be causing harm. The decision to revoke licenses had to be based on evidence provided by the National Poisons Centre and Centre for Adverse Reactions Monitoring (CARM). In the first nine months of the Act being in place, five products had their interim licenses revoked for these reasons.

However, on April 27, the Associate Health Minister Peter Dunne announced plans to change the Psychoactive Substances Act to revoke 

 interim product approvals. The amendment has not been tabled in Parliament yet, but it is expected that it will remove provisions for the interim period, thus making all currently approved products unapproved until they can go through the clinical testing process.

This would mean that no NPS products could be legally sold in New Zealand until the regulations for the clinical testing process are in place and products can prove they can pass. At a minimum, this will take 12–18 months.

Minister Dunne said that because the reports of severe reactions received by the National Poisons Centre and CARM cannot be attributed to any particular products, the government has decided to remove all products off the market. This is a departure from the legislation which focused on the need for evidence and due process to remove a product from sale.

The reasons for this change from the Minister are political. It is an election year in New Zealand and the continued sale of NPS products has created a perfect storm of NIMBYism, media fuelled hysteria and genuine concern about their effects. Two opposition political parties announced policies to change the law if they were in Government after the election. This forced the Minister’s hand in announcing the law change because he did not want to be seen to be giving the opposition parties a win on this issue.

Parliament is starting a two week recess period, which means that in the lead up to the change, retailers are likely to heavily discount products in firesales and people who use the products, or plan to distribute them, will be stocking up. New Zealand has already seen cases of discounting and there have been media reports of stockpiling. One shop which sells NPS products has been broken into and their entire inventory stolen.

The New Zealand Drug Foundation’s Executive Director, Ross Bell, explained that he suspects the decision to push through this amendment is about looking “tough on drugs,” as the Act already allowed the government to ban any substances that posed a danger to health. Mr. Bell has called on the government to use existing powers under the Act to remove the products that are causing harm, not to simply ban them all.

Find out more by following @nzdrug and visiting http://www.drugfoundation.org.nz/.

IDPC wishes to thank the New Zealand Drug Foundation for its inputs in this article.

U-turn in New Zealand legal highs regulations

On April 17, representatives from the development sector gathered to discuss the negative impacts of current drug policies on impoverished populations, and the importance of bringing the development perspective to the UN General Assembly Special Session (UNGASS) on illicit drugs in 2016. Broadening civil society engagement by including the development sector at the UNGASS will emphasize the cross-sectoral nature of drug policy and bring more power in numbers. Martin Drewry of Health Poverty Action and Eric Gutierrez of Christian Aid presented on the importance of recognizing international drug policy as a pertinent development issue.

Drewry began the discussion by highlighting the impacts of law-enforcement led drug policies on poverty. Although the intersections of drug policy and development are abundant, Drewry focused on three key categories of negative outcomes. First, current prohibitionist drug policies undermine governance, and therefore breed activities common to states with weak institutional structures, such as corruption and human rights abuses. Second, the authority of governments is limited by the power of drug cartels, which inhibits the state’s ability to protect and provide services to their citizens. Third, limited financial resources are wasted globally on fighting the war on drugs - this unintended consequence, known as “policy displacement”, means that available resources are diverted from both public health and socio-economic programmes.

Gutierrez continued the conversation by presenting the work Christian Aid has been doing to increase their understanding of drug policies within the development context. He pointed out that those who grow illicit substances do so as a survival mechanism and make the decision at a household level. Restricted access to land, and lack of food security and other sources of income, leaves farmers and their families with no other choice. Gutierrez stressed the importance of going deep into understanding the local context and the “messy politics” in order to address illicit drug situations. Although the UN Office of Drugs and Crime (UNODC) annually produced World Drug Report offers a comprehensive overview of the latest developments in drug markets, it is little more than an “impressive collection of snapshots.” Looking at illicit drug situations at one point in time is not useful without understanding the circumstances which led to the current situation, and projecting future scenarios. In order to enhance the collection of “messy politics” research in drug policy, Christian Aid is producing a series of case studies.

Jane Slater of Transform Drug Policy Foundation highlighted the failures of prohibition and made the case for regulating illicit markets. She echoed the concerns of the development sector, particularly those presented by Drewry and Gutierrez, regarding the distortion of development interventions by drug war objectives.

Jamie Bridge of IDPC then proceeded to provide an overview of the international drug control regime and the unique opportunity presented by the 2016 UNGASS to have an open debate about current drug policies and the way forward. For the development sector, the UNGASS is a crucial opportunity to advocate on an issue with so many ties to development and to the future of developing countries.

Please click here for more information about the 2016 UNGASS.

Please click here to read the briefing document created for the development sector about engaging at the 2016 UNGASS.

Development sector recognizes importance of advocating for drug policy reform at UNGASS 2016

In this HCLU video, Allan Clear, from the Harm Reduction Coalition, explains that we do need to regulate illicit drug markets to bring more control over these substances.

Harm Reduction Coalition: "We need a regulated market to control drugs"

The Economic and Social Council (ECOSOC) met on 23rd April 2013, and elected by secret ballot five members for five-year terms beginning on 2 March 2015. Four members were elected in the first voting round:

Following a subsequent special ballot to break a tie between Zhimin Liu (China) and Flore Ndembiyembe (Cameroon), 

ECOSOC elects INCB members

An INCB mission visited Iceland from 25 to 27 March 2014. The mission was conducted by the First Vice-President of the Board, Dr. Galina Korchagina, accompanied by Ms. Beate Hammond of the INCB Secretariat. The purpose of the mission was to discuss specific issues related to the country's implementation of the three international drug control conventions, to which it is party. This was the first mission of the Board to Iceland.

The mission met with senior officials from the Ministry of Welfare, the Directorate of Health, the Icelandic Medicines Agency, the Ministry of Foreign Affairs, the Ministry of Education, Science and Culture, the Ministry of Interior, the Directorate of Customs and the Metropolitan Police. The mission also had the opportunity to visit Vogur Hospital which is managed by SAA, the National Centre of Addiction Medicine. Meetings were also held with representatives from the Icelandic Red Cross as well as FRÆ, the Center of Drug and Alcohol Prevention.

Deliberations focused on recent developments in drug trafficking and abuse in Iceland, the Government's cooperation with INCB, measures taken by the Government to control narcotic drugs, psychotropic substances and the chemicals needed for their illicit manufacture and policies to reduce the demand for illicit drugs and to treat and rehabilitate drug users. The consumption of methylphenidate in Iceland was also discussed with the national authorities.

The findings of the mission will be reviewed by the Board at its forthcoming session in May 2014 and will be reflected in the INCB Annual Report for 2014, which will be published in early 2015.

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