Harm Reduction International (HRI) and the International Drug Policy Consortium (IDPC) welcome the opportunity to submit information to the Office of the UN High Commissioner for Human Rights for the preparation of its report under Human Rights Council Resolution 42/11 on human rights in the administration of justice. This submission addresses some of the current and emerging challenges specifically faced by people detained for drug offences and people in detention who use drugs.
Of the 11 million people currently behind bars worldwide, close to half a million people are incarcerated for mere drug possession, with an additional 1.7 million incarcerated for other non-violent drug offences,). That means that about 21% - or over one in every five prisoners worldwide - are being held on a drug charge. Punitive drug laws have fuelled mass incarceration and have impacted marginalised communities disproportionately, often on the basis of race, ethnicity, and/or poverty.
The criminalisation of drug use and possession and the adoption of disproportionate criminal penalties for all drug offences have resulted in the over-representation of people who use drugs in detention settings. According to global figures, people who use drugs make up about one-third to one half of the world’s prison population, and an estimated 56-90% of people who inject drugs will be incarcerated at some stage. People in detention report higher lifetime rates of drug use, including injecting drug use, than the broader community, along with more harmful patterns of use, such as sharing injecting equipment. One in three people in detention is estimated to have used drugs at least once while in prison.
For these and other reasons, including overcrowding, poor sanitation and inadequate health care, prisons represent high risk environments for the transmission of HIV and hepatitis C. Prevalence of these infections in prison populations is substantially higher than in the non-prison population. An estimated 3.8% of prisoners are living with HIV and 15.1% with hepatitis C.
This makes prisons important settings for the provision of evidence-based harm reduction services, including needle and syringe programmes (NSPs) and opioid agonist therapy (OAT), which have been proven to prevent the spread of HIV and hepatitis C. Sadly, only ten countries currently provide NSPs in at least one prison, while 59 countries provide OAT in at least one prison. Coverage of and access to these essential services remain inadequate where they are available.