The country’s major harm reduction service provider for people who use drugs is closing its needle exchange and opiate substitution therapy programs. At the same time, the government’s support for these programs is minimal, uncoordinated, and poorly managed.

As a result, drug-related HIV transmission has seen a concerning spike.

According to a recent report by the European Monitoring Centre for Drugs and Drug Addiction, the number of new HIV infections among people who use drugs has climbed from a relatively low 3 to 5 new cases each year between 2007 and 2009, to 231 cases in 2012. The sharp increase in this figure is unacceptable, and these numbers will continue to climb unless the government takes action.

This spike points to a desperate need for increased funding for harm reduction services, like needle exchange and opiate substitution therapy, that have been proven to slow the spread of HIV, drug-related crime, violence, and needless death.

According to the Romanian Harm Reduction Network, needle and syringe programs cost just €500 per person per year, compared to €6,000 for HIV treatment, making these services both lifesaving and cost-effective. And a recent joint risk assessment by European Monitoring Centre for Drugs and Drug Addiction and European Centre for Disease Prevention and Control cautions that the need for needle and syringe programs is sharply growing in Romania as funding is decreasing.

Needle and syringe programs had only recently been established in the capital, Bucharest, and now four of the six sites that had been working in the country are now closed.

The government’s lack of support for harm reduction services is a shortsighted calculation with deadly consequences.

If you agree, here’s what you can do to help:

Sign this petition urging the Romanian government to halt the spread of HIV.

Tell the Romanian government that it is time to act.

Stop the spread of HIV in Romania

On the 3rd July 2013, the UK Home Secretary Theresa May announced the government’s intention to ban the use of and trade in khat by classifying it as a Class C drug under the Misuse of Drugs Act 1971. This decision was taken despite the recommendation of the government’s advisory committee, the ACMD, that the substance should not be criminalised. The ACMD's recommendation was drawn from careful study of the available evidence of khat's medical and social effects.

Khat is a mild stimulant produced from the leaves of the plant 

. It has been used for thousands of years in East Africa and the Middle East, where it is embedded in social and cultural life, and is consumed in the UK by Somalis, Ethiopians, Kenyans and Yemenis. There are diverse patterns of consumption among these groups, and equally diverse views as to its effects on and place in community life. Typically, users meet to chew, relax and socialise in spaces called 

. Amongst these immigrant communities, khat is both celebrated and reviled, but recently the loudest voices have belonged to those campaigning for a prohibition on the substance, which they hold responsible for many of the problems affecting life in the UK's Middle Eastern and East African diaspora.

Concerns regarding the alleged effects of the drug on the social life of these communities prompted the Home Office to request the ACMD to review the advice given in its 2005 Report, which had found no grounds for banning the drug. Following its 2013 review, which specifically examined the linkages between khat and social problems, the ACMD again reported that: 'On the basis of the available evidence, the overwhelming majority of Council members consider that khat should not be controlled under the Misuse of Drugs Act 1971.' They regarded such controls as 'inappropriate' and 'disproportionate', and made a series of proposals for dealing with such problems as might arise in association with the use of khat.

So, why did the government decide to go ahead and ban the substance anyway, in the teeth of clear recommendations from its own advisors? Theresa May wrote to the ACMD and appeared to accept the scientific validity of their Report. However, she informed them that: 'The government is entitled and expected to take a broader view, taking into account other factors relevant to the issue at hand'. In other words, while the views of the boffins were fine in their place (the lab, the library or the ivory tower), out here in the real world, the government has to act. While thanking for ACMD for their 'extensive report', she more or less explicitly declared it an irrelevance.

Two basic sets of reasons were given for deciding against the Council's advice: firstly, that many of the UK's international peers had included khat in their own domestic drugs legislation, and the government feared that the UK risked becoming a regional hub for its trafficking. Secondly, that khat appeared to be linked to social problems afflicting the immigrant communities that use it. As mentioned above, the ACMD had specifically examined the linkage of khat and social problems, and had pointed to its complexity and the absence of any causal relationship.

In fact, it is clear that the government had, as has so often been the case in the past, already drawn its conclusions based on moral assumptions and beliefs, and had no intention of letting some pesky evidence get in the way of what it wanted to do.

Drugs have always functioned as symbols, standing in for the social problems which they are alleged to cause – in this case, social, cultural and economic vulnerabilities faced by the communities in which the practice of khat-chewing is lodged. The policy of criminalisation targets a symbol, leaving untouched the underlying social relationships responsible for poverty, marginalisation, etc. In addition, as pointed out by Dr Axel Klein of the University of Kent, who has studied the use of khat for many years, this particular policy hands a victory to the fundamentalists of political Islam, who drove the campaign to ban it. Thelocal 

 was often the only place where freedom of speech and association could be enjoyed outside the surveillance of fundamentalist zealots. As Klein observes: 'The trade has provided hundreds of UK Somalis with a livelihood, and their countrymen with a peaceful and agreeable past time.'

Drawing on a century of historical precedent, we can predict with some certainly that a change in the law will not eradicate demand; instead, the khat trade will be driven underground, to be controlled by organised criminals driven purely by profit, and bringing the khat chewers of the diaspora into contact with the full and fast-growing range of illicit drugs already on the market.

Governments have, it would seem, learned nothing.

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

Khat on a hot tin roof?

In July 2013, the Transnational Institute (TNI) in cooperation with Paung Ku (a consortium aimed at strengthening civil society in Myanmar) held the first Southeast Asia forum of growers of crops declared illicit in Yangon, Myanmar. As a senior policy officer for the International Drug Policy Consortium (IDPC), based in Bangkok and working primarily on drug issues in Asia, I took part to find out more about the situation faced by opium growers in the region. In the movement in support of drug policies more grounded in health and human rights, a lot of attention has been (justifiably) paid to establishing harm reduction approaches for people who use drugs. However attention is also warranted for people who grow crops declared illicit, who as I learned, can suffer from forced crop eradication initiatives, punitive law enforcement measures and damaging ‘development assistance’ projects. A first step in addressing these problems is the ability for their voices to be heard and to influence the design and implementation of drug and development policies that affect them.

In Myanmar, there are about 300,000 households involved in opium cultivation, and in Laos there are about 20,000 households, according to 2012 figures produced by the United Nations Office on Drugs and Crime. These households are often from ethnic minority groups and depend on opium cultivation for their livelihood, including access to education and health services. They are commonly driven to cultivating opium because of poverty and conflict as recognised by the European Union, which stated: “illicit drug crop cultivation is concentrated in areas where conflict, insecurity and vulnerability prevail. Poor health, illiteracy and limited social and physical infrastructure reflect the low level of human development experienced by the population in these areas.”

At the TNI-Paung Ku forum, growers shared experiences about the benefits of opium cultivation as including basic survival, medicinal use, ease of market access, ease and profitability of cultivation, and even use of opium in taming elephants and violent husbands! They also shared about the negative aspects of cultivation such as the insecurity of growing crops declared illicit, and the rise in crime rates, negative health consequences and broken familial and community relationships associated with dependant use of opium or—nowadays more often—heroin. By the end of the forum, many growers agreed on recommendations for addressing their situation which called for voluntary drug treatment services, decriminalisation of opium growers, sustainable farming practises, avenues for growers to raise their interests with policy makers, viable alternatives to cultivating opium, and preservation of the traditional and medicinal uses of opium. Some growers suggested that part of the opium cultivation could be legalised and the supply of opium regulated to produce medicines, but perhaps also for traditional medicinal and social uses.

It seemed like South East Asian and South Asian growers have a long way to go before they will be given the chance to contribute meaningfully to drug policy processes. This is partly because of the nature of geopolitics, conflict, politics and drug policies that characterise their environment. For example, the Myanmar government and the regional body Association of Southeast Asian Nations (ASEAN) of which it is a member, both declare a drug-free vision for their drug control strategies—which makes the prospect of partly legally regulating opium cultivation seem like an incredibly long shot. But at the very least, I hope that the realities of life confronted by opium growers in the region will be increasingly recognised and addressed in a humane and sustainable (in development and environmental terms) way by policy makers working on drug issues.

The first forum of growers of crops declared illicit in Southeast Asia

In June 2013, IDPC co-organised an experts roundtable with the Thailand Ministry of Justice Rights and Liberties Protection Department (RLPD). The meeting focused on how Thailand’s sentencing framework might be reformed to include a distinct category for people who use drugs and also engage in low level dealing to fund their drug use (often referred to as ‘user-dealers’, eg. refer to the European Monitoring Centre for Drugs and Drug Addiction). The roundtable follows on from a seminar held in September2012, co-organised by IDPC, RLPD and the Transnational Institute, to discuss and review effective legal frameworks for managing drug-related problems. For more background, see the IDPC blogpost on the seminar.

Thailand imposes a harsh regime for people who use or are dependent on drugs. Where an individual receives a positive urine test for use of a controlled drug, a court may sentence him or her to a minimum sentence of 6 months in a compulsory centre for drug users (CCDU) or as an outpatient in a community hospital. Their record with police is only deleted when they are deemed to have ‘passed’ the rehabilitation programme. Where an individual has not passed, they are required to go through the court sentencing process again which can lead to a term of imprisonment, or another term of ‘rehabilitation’ in a CCDU or community hospital. But where an individual tests positive for drug use and is also charged with another offence, including possession and supply of any quantity of drug, criminal penalties (involving a fine and/or term in prison) will apply for both drug use and any other offence.

The imposition of criminal penalties for the use and possession of drugs—whether for the ultimate purpose of personal use or commercial gain—conflicts with the principles of proportionality of sentencing for drug offences. Such drug “offences” are often committed because of occasional drug use, drug dependency or to meet basic economic needs. In these circumstances, services such as treatment, education, aftercare, rehabilitation or social integration should be offered as more humane, effective and proportionate alternatives to conviction and imprisonment. A proportionate sentencing framework would also incorporate these elements:

Distinctions between supply offences by referring to the type of drug involved, scale of the illicit activity, and role and motivation of the offender, eg. a distinction would be implemented between serious or organised traffickers, and micro-traffickers (low-level dealers or smugglers).

For micro-trafficking offences, reduced or provisional sentences, as well as alternatives to imprisonment, should be promoted.

The quantity of the drug involved should not be the only or major factor in determining the sentence for a drug offence. The socioeconomic circumstances in which an offence was committed and the financial gains of the offender should be considered as important mitigating factors. In circumstances where a person dependent on drugs is imprisoned, the provision of evidence-based drug treatment and services, along with HIV prevention services, should be ensured.

In response to the discussion of proportionality of sentencing, some roundtable participants were of the view that the problem with Thailand’s sentencing frameworks for people who use drugs was not the drug control laws but its implementation, which led to drug users being sent to prison instead of rehabilitation programmes. Government officials with responsibility for implementing Thailand’s rehabilitation programmes acknowledged that although compulsory centres remained a feature of the country’s treatment programme, more voluntary options were being introduced. One official commented that one key way that Thailand distinguished between different types of drug supply offences was through imprisoning large-scale traffickers in one facility, and low-scale traffickers in another facility—but acknowledged that Thai laws do not currently recognise user-dealers as requiring a different response such as alternatives to imprisonment.

A representative of the 12D network—the Thai coalition of civil society organisations advocating for harm reduction—urged policy officials to accept that it is common for people dependent on drugs to relapse in their drug use, even after participating in rehabilitation programmes, and not to impose punitive measures for relapses. She recommended that the government evaluate its investments in law enforcement and health interventions, to assess the benefits of investing more in measures aimed at addressing the health impacts of drug use. She also highlighted the need for the government to provide welfare services to meet the needs of communities, especially children, associated with people who use drugs, eg. where a mother or father has been imprisoned or detained in a CCDU and is not able to ensure the welfare of their children.

Researchers from the Chiangmai University Research Institute for Health Sciences presented the findings of their study on the experiences of people who use amphetamine-type stimulants (ATS) within the criminal justice system in Thailand. Their findings concluded that the majority of people in prison for drug offences are for offences related to ATS and amongst whom rates of HIV and tuberculosis are increasing. The study identified problems as including the implementation of arrest quotas for police which provides incentives for police to arrest people who use drugs (although police have also been known to refer users to treatment services), the detention of people suspected of using drugs while awaiting a urine test which exposes them to a range of police abuses, the lack of spaces in voluntary drug treatment centres which can increase the chances of people who use drugs ending up in prison or compulsory centres, and ATS users charged with criminal offences, such as possession and supply of drugs, not being eligible for rehabilitation programmes. Some of the key recommendations resulting from the study were:

alternatives to imprisonment should be implemented for people who use or are dependent on drugs and commit other low-level offences

people who use drugs should be diverted away from the criminal justice system and into voluntary community and/or drug treatment services, and

arrest quotas for police should be eliminated.

A representative of the Law Reform Commission ended the experts roundtable on a positive note by saying that both Thai drug laws and their implementation need to be reviewed, including police practices towards people who use drugs, with the aim of reforming drug policies away from the theme of ‘war on drugs’. He noted that a key part of reform involved changing public perceptions, or misperceptions, about what constitutes good drug policy. The Law Reform Commission is currently reviewing Thailand’s drug laws and may be able to include proportionality of sentencing on its agenda.

Please keep watching this space for updates on the review of Thai drug laws. A summary report of discussions at the experts roundtable will be published soon on the IDPC website, and an IDPC briefing paper on drug policy in Thailand is planned for publication at the end of 2013.

For further analysis and briefing on proportionality of sentencing for drug offences, you can check the briefing papers, which form part of the Series on Legislative Reform of Drug Policies published jointly by the Transnational Institute and IDPC:

Conviction by Numbers: Threshold Quantities for Drug Policy

Drugs, Crime and Punishment: Proportionality of Sentencing for Drug Offences

Towards more proportionate sentencing laws in Thailand 

During the US presidential elections last year, voters in the states of Colorado and Washington passed ballot initiatives to allow for regulated recreational cannabis markets for those aged 21 or over – a bold move contrary to both US federal law and the international drug conventions. The results followed a highly successful, sustained campaign in favour of the initiatives and, last week, IDPC attended a roundtable discussion with Rick Ridder and Joannie Braden from RBI Strategies and Research – a leading international campaign management firm that played a pivotal role in both states. The discussion focused on the campaign strategies that were developed, and to how these might be adapted for broader campaigning use elsewhere in the world.

The Washington and Colorado campaigns had similarities and differences. Crucially, both had already passed laws allowing for the medical use of marijuana, and its supply through a network of licensed dispensaries – meaning that much of the taboo and stigma around the drug had already been broken down. However, while the campaign for regulated markets in Washington had the support of former elected officials, law enforcement officers and some of the main media outlets – the Colorado campaign received no government support. Instead, it worked in a much more “bottom-up” way, supported by community groups, young voters and civil society groups. Opposition to the bills came from right wing voters, but also from some left wing voters (either those who feared the involvement of big corporations and the tobacco industry, or those opposed to any level of regulation for the drug). Also, many medical marijuana dispensaries stood against the bills, concerned about the possible impact on their own businesses. Yet there was no well-coordinated opposition campaign in either case.

When planning the Washington and Colorado campaigns, lessons were learned from an unsuccessful bill in California a few years previous. In California, where one key demographic seemed to change their mind as the voting neared, swinging the overall vote against the regulation of cannabis – women aged 30-50. Therefore, a large investment was made in Washington and Colorado to reach these voters in particular. In order to identify the most successful messages, the campaign team conducted web tests, focus groups, poll surveys, etc.



The key messages that emerged highlighted the failure of current prohibition, the need “to have a conversation” about the issue, and the socio-economic benefits of the regulation (such as reduced prison overcrowding, the freeing up of law enforcement resources, and tax revenue – with profits going on public investments rather than to Mexican drug cartels. In Colorado, specific focus was put on the tax income being invested in building new schools – language that made it into the final amendment itself in order to tap into a key local political issue and a widely acknowledged need (to the extent that some referred to the ballot initiative as the “education bill”).

The campaigns themselves included internet advertising targeted at the key demographics, email communications, well-researched advertisements on TV and radio, and discussions in public forums and local events. Interestingly, the design and branding of the campaigns steered clear of images such as marijuana leaves, joints, cannabis smokers – and even avoided the colour green! Instead, the campaign materials featured middle-age mothers in coffee shops, health workers and law enforcement officials.

Some of the main campaigning lessons that can be learned from Washington and Colorado include:

the need for careful planning and research before agreeing on target groups and language (for example, many activists wanted to emphasise that cannabis is less harmful than alcohol, but it soon became clear that this message did not work with the target populations)

the need to provide a clear exchange – what benefits can you offer in return for someone’s vote or support (in Colorado, for example, the trade-off was a vote in return for funding for new schools)

the need to relate campaign language to the local context, needs and “emotional chords” – touching on the issues and debates that generate the most interest and support (in Colorado, the issue of the lack of investment in schools)

The future of regulated cannabis markets in the USA has just begun – much is still undecided and many issues remain to be resolved (following the votes in 2012, even the models being developed by Washington and Colorado differ in many ways). Other states are considering similar moves, most likely at the next presidential elections in 2016, and other countries are watching closely to see how Washington and Colorado proceed.

How to run a campaign: Lessons from Washington and Colorado

VNGOC Chair Michel Perron used his podium time at the launch of the 2013 World Drug Report in Vienna last week to make a compelling case to CND member states about the value of their partnering with NGOs in preparation for the 2014 High Level Review of the 2009 Political Declaration and Plan of Action and 2016 UNGASS. Saying they could expect a “high return on investment of effective partnerships with NGOs,” and citing VNGOC’s recent track record supporting overdose prevention and HIV/AIDS resolutions, Perron assured delegates that “our members represent a significant and tangible strategic asset for your government to partner with.” The clear and concise but conceptually dense remarks contained a request that member states earmark a portion of their annual contributions to UNODC to support the VNGOC efforts to provide technical support and advice to member states on specific areas of concern through 2016.

The VNGOC membership meeting focused on presentation of the new Strategic Plan, which takes into account what Mr. Perron called an “explosion of interest” in VNGOC both by UN member states as well as new NGO affiliates. This interest is only expected to grow as member states’ attention focuses on demand and supply control strategies under global austerity, shifts to different substances and trafficking routes, and compelling regional initiatives such as the OAS Report. The highly publicized Global Commission on Drug Policy statements as well as effective NGO participation in the 56th CND have slightly shifted member states’ perspectives on the need for relevant and compelling information to assist in development of national and regional drug policies.

With Executive Officer David Turner undergoing treatment for lymphoma, Daniel Quittan, a Vienna insider, has been hired as part-time Project Officer to implement the stringent governance requirements and financial opportunities (which include qualifying for EU funds) that come with being an officially registered Austrian NGO. Since the Committee is asking member states to invest in VNGOC – to have a financial stake in it – in order to provide technical support and give NGOs an effective voice in the run up to the 2014 High Level Review and 2016 UNGASS, its ability to both be and 

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

Vienna NGOs: Taking responsibility for the future of world drug policy

A research conducted by the Colombian Government on the levels of purity and types of adulterants used to dilute cocaine, has recently been published. From a sample of three Colombian cities, it was discovered that more than 60% of consumed cocaine is in fact not cocaine at all, but cocaine-based paste. Likewise, users of other substances such as LSD and MDMA have reported modified substances generating adverse health effects and harms.

Civil society organizations have recognized that the adulteration of psychoactive substances is an inherent negative consequence of the prohibitionist regime. Focusing on harm reduction, these organizations are now generating strategies that are not only focusing on protecting users from harms associated with the substances, but also from the risks of consuming adulterated substances. It is on these lines that services aimed at analyzing psychoactive substances are gaining importance. These services provide immediate information for users wishing to know whether what they bought in the black market was what they had been told or not.

Given these developments, the NGO ‘Acción Técnica Social’ is proud to present their new services on substance analysis. These services are presented to partner organizations, substance users, and interested government stakeholders as part of a harm reduction initiative in festive areas: “Echele Cabeza cuando se de en la cabeza” ("Use your head when you get high"). Since late last year, and with support from the Spanish organization “Energy Control”, ATS has been developing an important and necessary service to protect the integrity and health of people who use drugs in the city of Bogota.

At the moment, the ATS substance analysis service is designed as a mobile unit to be utilized at parties and events where substances such as 2CB, MDMA, amphetamines, and cocaine are used. The mobile unit provides information on whether substances have been adulterated or are what they were described to be. In such cases, further information on how to avoid associated risks is given to users.

“Echele Cabeza cuando se de en la cabeza” is an initiative supported by the Colombian Ministry of Social Protection. ATS has established an agreement with the national government to provide field-work information relating to the early recognition of new substances and adulterants in Colombian streets. Released last week, the first information alert confirmed the presence of adulterated LSD among the substances sold in Colombia. An example of a substance also found in other countries is the compound 25I-NBEOMe (2CI), identified by the Energy Control team.

We consider the current agreement with the national government as important since it allows greater reach for efforts aimed at protecting the health of users. Nonetheless, ATS encourages the Colombian government to publicize their support and promote the visionary strategies that have been proven successful in contexts similar to the Colombian one. In the future, ATS hopes to implement services where users are able to leave their substances for analysis. Users would be able, after a defined period of time, to check online the contents of the analyzed substance. At any rate, ATS hopes that before the end of the next semester, they will be able to conduct a major sample collection. Even though the substances to sample are yet to be decided, the purpose of this project is to create a detailed sample of substance use in the city of Bogota.

At a time where both the ‘good’ and the ‘bad’ are being globalized, ATS trusts in international cooperation to place at the disposal of partner organizations all the information they will compile. ATS considers of extreme importance the fact of being able to share data on trends in drug use and the composition of substances. This will allow us to provide better services that efficiently protect people who use drugs.

Let’s continue to move forward on the construction of open, free, and just societies.

Qualitative drug testing: Harm reduction programs in Colombia 

 global campaign, members of the Thai Civil Society Coalition for Harm Reduction (12D Network), human rights activists and people who use drugs attended a street rally to raise awareness of the harms caused by the ‘war on drugs’. We gathered at the front of Government House, holding banners demanding drug policy reforms to end the criminalisation of drug use, violations against drug users and compulsory treatment.

The 12D Network had prepared a letter to the Prime Minister, Ms. Yingluck Shinawatra, demanding that the government reform its drug control policies. On her behalf, the Secretary -General of the Office of Narcotics Control Board (ONCB), Pol. Gen. Pongsapat Pongcharoen, met with the 12D Network at the rally and officially received the letter. The Secretary-General addressed rally participants and committed to meeting with the participants again next week for a more detailed dialogue about the letter, which comprised 5 requests of the government:

support and implement harm reduction and evidence-based policies on drug use

provide more resources to implement prevention and healthcare and harm reduction services for people who use drugs

review and reform laws and policies to end the criminalisation of people who use drugs

support voluntary rehabilitation and treatment methods that are based on evidence and human rights, and end the imprisonment of people who use drugs, and

provide more opportunities for Thai civil society organisations and drug user networks to participate in policy making processes.

The day before the rally, the Thailand Law Reform Council Rights Protection Sub-Committee organized a public forum called 

’10 years of Harm Reduction Policies in Thailand: Rights Promotion or Violation’.

 The purpose of the forum was to review Thailand’s drug control policies in the last 10 years since the Prime Minister at the time, Mr. Thaksin Shinawatra, declared a war on drugs in Thailand. A range of speakers from government, health services and civil society spoke about the need to address the stigmatization and discrimination against people who use drugs, particularly amongst healthcare providers, and to incorporate evidence-based approaches in the rehabilitation system.Mr. Veeraphan Ngammee of the 12D Network highlighted the fact that the number of new HIV infections in Thailand has been increasing since 2003 from 10,000 to 1.2 million, indicates that the government’s drug control policy has been ineffective. Concrete suggestions for improving Thailand’s drug policies included reforming drug laws, raising public awareness about drug use and dependence, ending compulsory treatment and introducing voluntary options, and ensuring better balance between law enforcement and health in developing and implementing policy measures.

These activities are steps forward for the reform of drug control policy in Thailand. The 26 June rally was perhaps the most successful demonstration to date of drug user networks, as it elicited a positive response from government that have never before been witnessed. The next steps forward for improving drug policy in Thailand will hopefully be witnessed by us at the dialogue next week promised by the Office of Narcotics Control Board.

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

26 June Day of Action in Bangkok, Thailand

The Obama administration’s statement, 'A Drug Policy for the 21st Century', makes satisfying reading. Basically, the White House is saying (publicly through its own website) that it accepts that the decades of US drug policy reliance on widespread arrest and harsh punishment of people who use drugs has been an expensive mistake. This has been coming for some months now, with increasingly clear statements from the US federal administration that a change of direction is needed in drug policy, but the clarity of this statement is crucial, in that it finally puts to bed any notion that the ridiculously harsh US sentencing policies for non-violent drug offences can produce any benefit for American society.

I commend Drug Czar Kerlikowske, and the other advisers to President Obama who must surely have approved this statement, for their bravery in making this step. However, the obvious question now is – if you now accept that mass incarceration was a mistaken and ineffective policy, what do you plan to do about the hundreds of thousands of Americans who will spend tonight (and many more nights) in prison as a result of this mistake. There are a wide range of legislative initiatives aiming to reduce the use of incarceration for non-violent drug offences in the future, but nothing that addresses those currently languishing in US prisons under this injustice.

As someone who has disagreed with much of US drug policy for the three decades I have worked in this field, it is heartening to be increasingly finding more to support than to condemn. I do however, foresee some remaining problems with some of the other proposals in Mr Kerlikowske's statement:

The focus on prevention. While in theory it is of course better to prevent a problem than respond to it later, one of the lessons of the last 30 years is that prevention programmes may do a lot to raise awareness of risk, and improve self-esteem and decision making, but are not a key factor in reducing overall drug use prevalence. If the White House sets ambitious prevalence reduction targets on the back of an increased investment in prevention, it is likely to be disappointed.

Similarly, the commitment to early screening and intervention with those developing drug problems is welcome, but it is important to recognise that recovery rates amongst those receiving those interventions are relatively low. We are better at treating long entrenched drug dependence than we are in preventing its onset.

Finally, the commitment to promote the US Drug Court model internationally carries real dangers. Offering alternatives to custody is a much needed reform in many countries, but the drug court model is an expensive one (that most countries cannot afford) and still applies tough sanctions to relatively minor offenders. There are many more cost effective ways to divert minor offenders to treatment and support (see the IDPC Policy Guide), and the US authorities need to promote the full range.

The US Federal Government has unrivalled diplomatic and human resources around the world with which to promote humane and effective drug policies – I hope that this new 21st Century approach will now be reflected in their work.

Mike Trace, IDPC Chair and former UK Deputy Drug Czar

Real change we can believe in

Last month, Harm Reduction International hosted the 23rd international harm reduction conference in Vilnius, Lithuania. Around 800 participants attended from all around the world to share latest experiences, developments and evidence – and the sense of community was noticeable from the opening.

As always at these events, there was a huge range on offer – from traditional presentations to ‘dialogue space’ discussions, an international film festival, and a music concert by local superstars Ball and Chain! Such spoils inevitably meant that no-one got to see everything they wanted to, and this was exacerbated by the large number of important side-meetings taking place as well as groups sought to take advantage of being in one place at one time.

One such event was an IDPC Members Meeting, at which around 40 people met over lunch to discuss the network’s work and the opportunities coming up (see picture) – reflecting on the recent developments in Latin America and New York among many other things.

Highlights from the main programme included video addresses from Richard Branson and Stephen Lewis, a great speech from former Polish President President Aleksander Kwaśniewski (now a member of the Global Commission on Drug Policy), and Ethan Nadelmann from the Drug Policy Alliance in the USA. From IDPC’s perspective, we launched our new Drug Policy Advocacy Training Toolkit during a lunchtime session and Secretariat staff presented on a wide range of topics – such as amphetamine-type substances, the Community Action on Harm Reduction project, and the history of drugs and sex work in the twentieth century. It was also a great opportunity to further promote the Support. Don’t Punish. campaign.

Overall, the conference was a great success and an invaluable opportunity to be with colleagues and allies at an important time for harm reduction and drug policy reform. For more information, please visit the conference website: http://www.ihra.net/conference

Reflections from the International Harm Reduction Conference 

It was nearly standing room only Monday at UN Headquarters in New York, for a presentation of the Organization of American States’ reports on “The Drug Problem in the Americas” and the Declaration of Antigua Guatemala, “For a Comprehensive Policy against the World Drug Problem in the Americas,” adopted during the 43rd Regular Session of the Organization of American States General Assembly in La Antigua, Guatemala from 4 to 6 June 2013. The event was sponsored by the Permanent Mission of Guatemala to the United Nations, in collaboration with IDPC, Harm Reduction Coalition and the New York City Bar Association Committee on Drugs & the Law.

, the Minister of Foreign Affairs of Guatemala, who was followed by 

Drug Policy Coordinator, México Unido Contra La Delincuencia and Transform Drug Policy Foundation, and 

Advocacy Director, Health and Human Rights Division, Human Rights Watch. The event was moderated by 

IDPC Associate and Senior Fellow at The Washington Office on Latin America.

Coletta Youngers opened the discussion with a brief background of the OAS meeting, where for the first time, OAS placed its main focus on drug policy issues. Coletta discussed the OAS’s analytical report and scenarios exercise, and the Declaration of Antigua Guatemala, which among other things, calls for a Special Session of the General Assembly of the OAS in 2014, as a lead up to the drugs UNGASS to be held in New York in 2016. Coletta pointed out that while many countries in the region are calling for alternative policies, there’s certainly no consensus on what those policies might be – rather we are at the beginning on a very long and interesting debate, and are focused on moving that debate forward. Underscoring the important role of civil society organizations, she talked about the Antigua declaration setting forth a very comprehensive set of recommendations made by a diverse group of civil society members.

Minister Fernando Carrera Castro then gave his address. He discussed his history with drug policy reform starting with his days advising President Otto Pérez Molina, who, in the face of adversity and intense criticism, has for many years advocated for finding an alternative to the “War on Drugs”.

The Summit of the Americas in Antigua was a turning point in this regard. Well-attended by many high level leaders, the consensus from the meeting was that, although drastic change in the short term was not likely, “adjustments” are needed, primarily with respect to: changing the focus to health and human rights, decriminalization, prevention of violence, and discussing the socioeconomic aspects of the problem and developing social policy in response. It was recognized at the meeting that a shift from a multi-disciplinary approach was needed instead of continuing to focus on interdiction. In the end, it was acknowledged that these “common sense” policies must be a topic of public debate so that a new strategy could be developed over the next 3-4 years in the lead-up to 2016. In the end, Minister Carrera stated that “we’re just starting these discussions – we don’t know where we’ll be in 10 years time, but we’re starting a change in approach,” and acknowledged that the 21st century “deserves a more scientific approach to drugs, not just a continuation with a repetition of what we’ve done in the last 50 to 60 years.”

Lisa Sánchez followed with a discussion of the actual process of drafting the OAS reports and the methodology: the report composed of two components including 1) the analytical report, which addressed different dimensions of drug problem in Americas (where are we?), and 2) the scenarios report, showing four narratives of what drug policies could look like from 2013 to 2025 (where could we be?). The scenarios report, the more forward looking of the two, shows four narratives, or “stories”, each with its own focus, such as security, legal alternatives, health and strengthening of communities, and conflict and disruption of adopting different policies in different countries. She pointed out that it was important to note that these are not meant to be a set of recommendations, but a useful baseline document to foster debate and promote national, local and regional dialogues on drug policy in order to better understand what the real possibilities of change are and how can we as governments and civil society actors can respond to support drug policy reform.

Lisa then explained the four scenarios briefly: 1) “together”, with an emphasis on security policy; 2) “pathways”, with a focus on legal regulation; 3) “resilience”, with a focus on strengthening of communities; and 4) “disruption”, which has as its solution the deprioritizing of enforcement in transit countries. All of the scenarios introduce some degree of change, although none of them are mutually exclusive; rather, it is up to governments to take the four of them and try to understand how drug policy can evolve and get a clear idea of what a post-prohibition world could look like if one or another decision was made. Ultimately, the scenarios report provides a good baseline tool moving forward to address the drug problem both hemispherically and within the UN in 2016.

After Lisa’s presentation, Coletta pointed out the widely divergent needs and goals among nations especially within Latin America, and that there was therefore the need for corresponding flexibility.

Finally, Rebecca Schleifer gave an impassioned presentation on the topic of human rights and drug policy, acknowledging the great strides made in the area– indeed at the session of the Commission of Narcotic Drugs in 2009, the very mention of the words “harm reduction” raised alarm bells.

Rebecca discussed Human Rights Watch’s position of opposing criminalization of possession for personal use. HRW has been documenting human rights abuses relating to drug control efforts for more than 15 years and has found that in countries throughout the world, criminal law relating to drug use and related law enforcement practices facilitate or exacerbate serious human rights abuses, ranging from torture, ill treatment and extrajudicial killing to denial of basic health services. Despite the fact that individuals have the human right to seek life saving health services without fear of punishment or discrimination, the research in many countries shows that many people do not carry sterile equipment and do not take advantage of health services geared towards drug users because of fear of being branded a drug user.

Rebecca pointed out that while the trend seems to be on the emphasis of drug treatment, not incarceration – couching drug users as patients, not criminals – seems at first to be progressive, there are serious problems with this approach. First, the vast number of people who use drugs do not need treatment. Second, treatment is extremely limited and many facilities don’t meet human rights standards.

In two instances of “calling out the elephant in the room,” Rebecca discussed human rights abuses in Guatemala involving 6,000 people held in up to 200 “evangelical prayer camps” ostensibly for the purposes of treatment. Drug users are taken off the street, by field hunting parties (

), by the police, family members or voluntarily. They face difficult conditions inside these facilities, including harsh penalties if they want to leave and little government oversight. In the second instance, she discussed the primary donors to the drug control system– the United States, for example (who were, actually, in the room) – and pointed out that with major donor status comes a responsibility to see that human rights are not violated in the process.

Rebecca also discussed progresses made, domestically and internationally, in drug reform –for example, decriminalization of possession for personal use, protecting access to harm reduction services, supervised injection sites; and prison-based needle exchange.

In closing, she discussed reform under the international drug conventions – the Declaration of Antigua noted the importance of “fully implementing” the Conventions, and Rebecca expressed hope that “fully implementing” would mean that governments use the flexibilities permitted in the drug conventions, which INCB recognizes, such as the decriminalization adopted in Portugal. She emphasized, however, that HRW’s position is that states need to seek amendment of the Conventions insofar as they conflict with human rights obligations – including efforts to permit decriminalization of possession for personal use.

The session ended with a brief question and answer session, which touched on the connection of the OAS reports and Declaration with the process leading up to the High Level Review scheduled for the 57th Session of the Commission on Narcotic Drugs in 2014 and the UNGASS to be held in New York in 2016.

Guatemala Minister of Foreign Affairs presents results of OAS General Assembly meeting, focused on drug policy, to full house at UN Headquarters in New York

“I was arrested for drugs when I was 19-year-old, now I am 32-year-old. Thirteen years have passed but even now I can be imprisoned anytime. I live under the threat of police. Use drugs once and become a criminal for life,” rued Vinod (name changed) as he took part in a Support. Don’t Punish event in New Delhi.

These words ably illustrate the consequences of the punitive laws that criminalize drug use in India. As part of efforts to raise awareness and speak against harmful policies, India HIV/AIDS Alliance joined the Support Don’t Punish campaign with Global Day of Action activities in New Delhi to raise awareness of the harms caused by the criminalization of people who use drugs.

At busy service sites for people who inject drugs (PWID) in the Yamuna Bazar and Jahangirpuri sections of the city, we shared Support. Don't Punish stickers and posters and spoke with PWID about how June 26 has long been observed as “anti-drug day” with public arrests of PWID along with the disposal of seized drugs. Our campaign aimed to reclaim the day as one to support PWID.

PWID from both sites volunteered to join us as we headed to our rally at Jantar Mantar, a historic area of New Delhi. Here the group grew as it was joined by more representatives from drugs users groups and other activists to observe a silent march to bring the issues of PWID to the notice of decision makers and the general public and encourage policy reform to promote our health and human rights.

Our last stop of the day was at Sahara House, a community-based drug treatment center, where we took part in an interactive session facilitated by Tripti Tandon a prominent lawyer from Lawyers Collective. PWID shared their experiences, and Tripti noted that though the law allows for a PWID to avail detoxification, this provision is often overlooked by law enforcement.

As our Day of Action ended in New Delhi, we hoped it would mark a turning point for PWID.

There are signs of change. As we raised community voices on 26th June, a group of international technical experts urged the Prime Minister of India to end the War on Drugs. Is a new consensus forming? As our banner proclaimed, “The War on Drugs kills us!” In India, this War has been lost, leaving behind only death. We need to move past futility and toward solutions that work for PWID.

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