Category Archives: US drug policy

Yes, legalizing marijuana breaks treaties. We can deal with that.

By John Walsh, Tom Blickman, Martin Jelsma and Dave Bewley-Taylor

This Op-Ed was originally published in iPolitics on December 11th, 2017

Buzzing in the background of Canada’s debate on cannabis legalization is the issue of the three UN drug control treaties, and what to do with them.

The issue arose during the House of Commons’ consideration of Bill C-45, and may well come up again now that the bill is coming under Senate scrutiny. There is no doubt that legalizing and regulating cannabis markets for non-medical use will mean Canada is no longer in compliance with the obligation under the treaties to restrict cannabis to “medical and scientific” purposes. And Canada will need to address those treaties — in due time.

However, what ‘due time’ should mean has been the subject of some alarmist commentaries. It has been argued that Canada should have initiated the process of withdrawing from the treaties by this past July 1 to avoid a breach of international law when cannabis is legal for recreational use in July, 2018, as the government intends. Some have suggested that, by missing this supposed deadline, Canada has now limited its legal options and might even suffer international sanctions if its reforms continue as scheduled.

This raises two key questions. Did the supposed July 1 deadline really exist? And does Canada really now have fewer options with regard to managing the mismatch between cannabis regulation and UN drug treaties?

The 1961 UN Single Convention specifies that if formal notification of withdrawal from the treaty is submitted before July 1, it takes effect on January 1 of the next year; if notification is submitted after July 1, then withdrawal takes effect a full year later. But at this stage in Canada’s reform effort, the mechanics of the treaty withdrawal process do not dictate hard deadlines. The alarmism about treaty violations, deadlines and delays is misplaced.

Canada certainly has important decisions to make about how to ensure that its impending cannabis reforms will align with its international obligations. As we describe in our report Cannabis Regulation and the UN Drug Treaties: Strategies for Reform, a range of alternatives merit Canada’s careful consideration. Beyond simply withdrawing from the drug treaties, these options include the possibility of withdrawing from and then rejoining the treaties with reservations (a procedure that Bolivia used with regard to coca) or of modifying certain treaty provisions by means of a special agreement among a group of like-minded countries.

In reviewing its options, Ottawa would be wise to be protective of Canada’s positive reputation as a country that upholds international law. But there is no need to postpone the regulation of cannabis, and there is also no reason to rush to withdraw from the drug treaties — certainly not before the relevant legislation has even become law, and not even immediately afterwards.

The experience in Uruguay — the first country in the world to regulate cannabis — demonstrates why immediate withdrawal from the treaties is not necessary. Having justified its policy position via its human rights obligations, Uruguay has suffered no negative consequences beyond mentions in the annual reports of the International Narcotics Control Board (INCB), the watchdog of the UN drug conventions — noting that the country’s law regulating cannabis is contrary to the provisions of the drug conventions and urging a resolution.

The United States — where eight states have legalized adult-use cannabis and where the federal government has adopted a policy of accommodation — has received a similar message from the INCB regarding Washington’s legally dubious interpretation of the drug treaties.

Canada has better and more legally-grounded options, and plenty of time to consider them carefully. A good starting point would be for Canada to publicly acknowledge that moving forward with regulation of adult-use of cannabis will result in a period of respectful non-compliance with certain treaty obligations — a route that, in the absence of a seamless transition, displays the appropriate regard for international law.

Canada could explain the reasoning behind its reforms and why the country’s new regulatory approach is justified by the need to realize other domestic and international legal and policy commitments, particularly with regard to public health, child protection and human rights.

Canada is not alone in reforming its cannabis policy, nor is it the first. In addition to Uruguay and the eight U.S. states, many local authorities in other countries, notably in Europe, are pushing national governments to follow suit. In the Netherlands this has resulted in the October 2017 decision of the new coalition government to allow for experiments with regulated supply of cannabis to coffee shops. This would extend toleration of cannabis sales in these premises to tolerated regulation of the supply.

Meanwhile, the World Health Organization has initiated a review of the classification of cannabis under the drug conventions. Canada’s cannabis regulation is part of a bigger trend and there is no reason to rush to unilaterally withdraw from the drug conventions. Acting unilaterally may not even be in Canada’s best interests; it could be wiser to act in concert with like-minded states.

The bottom line is that Canada ultimately will need to choose a path forward with regard to cannabis regulation and the drug treaties. But there is no need for hasty decisions and plenty of time for Canada to evaluate its options — and act when the time is ripe.

John Walsh is director for drug policy at WOLA (Washington Office on Latin America) in Washington, DC. Tom Blickman is a senior policy analyst and Martin Jelsma is director of the Drugs & Democracy program of the Netherlands-based Transnational Institute (TNI). Dave Bewley-Taylor is director of the Global Drug Policy Observatory (GDPO), Swansea University, U.K.

Read the Original Publication Here

British System, American Century: A short case study

British System, American Century: A short case study

Chris Hallam

This blog shows the intimate ties between the international and domestic domains of drug control. This is a well-known phenomenon; however, it involves considerable complexity. The lengths to which governments will go to reduce potential tension at the international level are apparent. This is especially so when states – as in the following case – are wary of the US position. At the same time, powerful domestic forces can counteract the influence of international powers, even when the United States is concerned, as in the aftermath of the Second World War.
The blog selects the example of Britain during that period in which the negotiations leading to the Single Convention were taking place. The then-famous ‘British System’ of drug treatment was a key aspect of Britain’s drug policy relationships; stemming from Sir Humphrey Rolleston’s inquiry into addiction that reported in 1926, the ‘British System’ permitted any doctor to supplyheroin, morphine, cocaine and other drugs to those who were dependent upon them. Unlike the present mode of ‘Heroin Assisted Treatment (HAT), the British System imposed few requirements on patients, who could take their prescription to a pharmacy, collect their drugs and consume them more or less at will. This depended on the regulatory context, the liberal views and the largesse of the doctor, but these were generally forthcoming.
Both the international and the domestic domains played a part in the changes that overtook the British regulatory framework in the 1950s and 60s, leading to the demise of the ‘British system’ of prescribing and its replacement with a much more restrictive ‘clinic’ system in 1968. The international dimension was always important, but in the period preceding the agreement of the 1961 Single Convention, it was especially significant as countries sought to shape the draft treaty to suit their national interests, or (less rationalistically) to forge the global order of intoxication according to their mythological image.

Sir Humphrey Rolleston

Following the war and the continuing rise of the United States as an international military, political and economic superpower, there was friction between it and Britain over aspects of the latter’s drug policies. The 1955 American attempt to impose a global prohibition on heroin was eventually faced down by the British government after internal pressure from the medical profession in support of the drug’s retention in medical therapeutics, including in the treatment of drug dependence. The medical profession was a powerful force in British politics and culture, sufficient to bring the government to resist US pressure.
Britain’s representative at the Commission on Narcotic Drugs (CND), the policy-making body for the new UN international drug control system, was J.H. ‘Johnnie’ Walker. Bing Spear, the Home Office civil servant who had written extensively on UK drug policy, identified Walker as providing the initiative that led to the first Brain Committee, which, commencing its meetings in 1958, reviewed the British drug control system for the first time since Rolleston did so in the 1920s. Government documentation from the mid- to late-1950s supports this claim. The context for Walker’s views was largely international, with the British System undergoing criticism from a number of countries, particularly the United States, through the mechanism of the new United Nations drug control regime.
In 1955, Walker sent a lengthy and thoughtful memorandum to the Home Office suggesting that it was time to look again at the British drug control system. Despite the system’s smooth domestic running, said Walker: ‘It so happens that a number of problems have arisen, or are on the horizon, which indicate that this is a suitable moment to review the present system of control.’ These problems or potential problems included the proliferation of new synthetic drugs such as pethidine and methadone; the UK policy on addiction (by which was meant in particular the Rolleston-inspired regulations permitting the long term of maintenance of opiate habits and the belief in the ‘stabilised addict’); addict doctors; and improper prescribing and supplies to addicts (the issues surrounding ‘script doctors’). The memorandum paid the greatest attention to the second and the fourth of these categories, replicating the situation that obtained when the Rolleston Committee reported and showing that the issue of doctors prescribing dangerous drugs to addicts had remained at the heart of governmental anxieties. Walker claimed that the Rolleston Committee never intended the ‘lavish supply of dangerous drugs to addicts merely for the maintenance of addiction’. He then made reference to a ‘small but potentially dangerous group of drug addicts (mainly heroin addicts) in London at the present time’. This group was ‘disturbing’, as it represented ‘the first real sign of a significant increase in heroin addiction for very many years’. The group’s members had become addicted young and were mostly under thirty – often nearer twenty; many shared an involvement in one particular field of entertainment and therefore met socially at regular intervals – a reference to the jazz club scene. The social context of this drug use made it ripe for proselytism, contended Walker, ‘always one of the more dangerous features of drug addiction’.
He continued that many ‘appear to obtain supplies from a small number of doctors who make no attempt whatever at cure or even, so far as can be judged, at reduction of the dose. In other words, their addiction is deliberately fed, almost certainly in some instances for purposes of gain.’ Walker concluded that: ‘The “script doctor” who thus makes drugs freely available to addicts represents a special problem…’
Walker’s memorandum showed that the Home Office was by this time fully aware of the flourishing new London addict subculture, a full ten years before these facts were published in the Second Brain Report. As noted by Spear, the peculiar thing is that the first Brain Committee did not address it in their deliberations nor their report. At the Home Office, it was Tom Green (who succeeded Walker at the Drugs Branch) who led the drafting of the advice and information sent to the Ministry of Health, from which emerged the shape of the review. For ‘some inexplicable reason’, while drawing heavily on Walker, Green did not include evidence of the emergence of London’s expanding heroin subculture.
One possible reason for this startling omission lay in the international relations around the topic of drug control. Walker points out that US medical opinion was firmly against maintenance and the notion of the stable addict. The ‘strongly held’ view in the American medical profession was that it is ethically unacceptable to condemn a patient, especially a young patient, to perpetual addiction by offering this form of treatment. It was also remarked that the CND and World Health Organisation were highly critical of ambulatory treatment of the kind practiced in the UK. Indeed at its 10th session, the CND ‘expressed the view that ambulatory treatment (including the so-called “clinic” method) was not advisable and asked the World Health Organization to prepare a study on the appropriate methods of treatment.’ Furthermore, a clause had recently been inserted into the draft Single Convention which spoke of treatment being given on ‘a planned and compulsory basis, in properly conducted and duly authorised institutions’. However, by virtue of a qualifying clause that was initiated by the UK, such measures would be applicable only in those countries having a large addict population; it was this proviso that permitted the UK government to sign the 1961 treaty despite its differences with respect to drug treatment. Notwithstanding this, Walker expressed concern that the general trend at the CND was toward compulsion, and that there may in due course be concerted pressure for the removal of the UK clause. He added that, ‘it is unlikely that the United Kingdom could ever accept an obligation to require compulsory treatment of drug addicts in a closed institution’. In fact, Walker made it clear that such a measure could prevent the UK from signing the treaty, and would have been in conflict with the overall trend of mental health policies in Britain at this time, as expressed in Lord Percy’s 1957 Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency. This optimistic document led the trend away from confinement, toward voluntary and community based mental health treatment, and fed into the 1959 Mental Health Act. In relation to addiction, Walker commented in closing that: ‘There is a limit to what the State should attempt, and the deprivation of personal liberty for medical reasons is far too serious a matter to contemplate unless there is overwhelming evidence of the need for it because of some widespread and particularly virulent social problem. This need does not exist in the United Kingdom’.
This last sentence is the key one. In order to fight its corner at the CND, the UK government needed powerful evidence that the domestic drug problem continued to be so small as to be negligible, a point which some other countries disputed. Consequently, ‘there would be much to be said from the point of view of strengthening our case in international circles for obtaining an authoritative opinion from a body of experts on the necessity for, and the feasibility of, providing special treatment for drug addicts in this country.’77 In other words, a Committee set up to review Britain’s arrangements could prove very useful in providing the government with ammunition which to fight its international drug policy corner, so long as this evidence indicated that the problem was tiny and relatively insignificant.
Although, as Spear claims, Walker’s superiors at the Home Office were initially unreceptive to his argument, the Brain Committee may well have been influenced by it at the meetings which produced the first report. Green led the way in producing the documentation for the Committee; mention of the expansion of the opiate subculture was entirely absent, and the growth in heroin addiction strongly downplayed. Accordingly, its Report was structured on precisely the lines that would support the government in its negotiations at the CND. It stated baldly: ‘After careful examination of all the data put before us we are of the opinion that in Great Britain the incidence of addiction to dangerous drugs… is still very small.’
This argument remains for the present a speculative one; nonetheless, the omission of the West End heroin subculture from the Home Office memorandum of evidence to the first Brain Committee, and the Report’s conclusion, which supports the UK’s requirements at CND in the run up to the 1961 Single Convention, are highly suggestive. Beyond this specific question, however, it is clear that the construction of international drug policy is a matter of both international and domestic (and transnational) domains, and that it is impossible to understand countries’ conduct in international fora without taking into account international politics and culture. And vice versa.

Dr John Petro

[1] Departmental Committee on Morphine and Heroin Addiction: Report (London: HMSO, 1926). (Rolleston Report)

[2] 59 D. R. Bewley Taylor, The United States and International Drug Control, 1909-1997 (London and New York: Continuum, 1999) p.141.

[3] Spear, H. B. & (ed) Mott, J. Heroin Addiction, Care and Control: The British System. London: Drugscope, 2002. Pp.65-89.

[4] Spear, H.B., Heroin Addiction, Care and Control p.90

[5] The National Archives HO 319/1 and MH 58/565.

[6] McAllister, W. B. Drug Diplomacy in the Twentieth Century: An international history. London and New York: Routledge, 2000. Pp.185- 211.

[7] TNA HO 319/1 ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955.

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Ibid.

[12] Ibid.

[13] Spear, H.B., Heroin Addiction, Care and Control, p.92.

[14] Ibid.

[15] The Tenth Session of the Commission on Narcotic Drugs, 1955. http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1955-01-01_2_page005.html Accessed 3rd September 2016

[16] TNA HO 319/1, ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955. In this passage, Walker was quoting from a 1954 CND draft of the Single Convention.

[17] Ibid.

[18] E. Percy Baron of Newcastle Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency (London: HMSO, 1957).

[19] TNA HO 319/1, ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955.

[] Report of the Interdepartmental Committee on Drug Addiction 1961 London: HMSO. Paragraph 24.

Why is coca production on the rise in Colombia?


After countless reforms and billions of investment eradicating coca cultivation is still a great challenge for Colombia.

Ross Eventon, GDPO

Early March, 2017: The United States government and the United Nations announce large increases in the amount of coca being cultivated in Colombia.

The head of the US Bureau of International Narcotics and Law Enforcement Affairs flies to Colombia and meets the President. The increase is due to the end of aerial fumigation operations, he says, but he also assures the press that he would not be asking the government to restart that policy….
Continue reading full open access article here: http://www.aljazeera.com/indepth/opinion/2017/04/coca-production-rise-colombia-170419130227958.html

View from the Ground – Harm reduction, drug policy and the law in the Maghreb: focus on Morocco and Algeria

View from the Ground – Harm reduction, drug policy and the law in the Maghreb: focus on Morocco and Algeria

Khalid Tinasti, Geneva
Global Drug Policy Observatory, Swansea University
October 2016

As WordPress doesn’t allow referencing, full PDF with references available here: khalid_blog-maghreb-drug-policy_final

Introduction:

The Maghreb countries, part of the Arab Maghreb Union, are Algeria, Libya, Mauritania, Morocco and Tunisia and form the largest part of North Africa. These countries are currently in the centre of the boiling issues of the world including terrorism, human trafficking and drug trafficking. These countries are large consumers and producers of plant-based and synthetic l psychotropic substances, Morocco being the largest cannabis producer in the world in 2014. But when it comes to discussing the issue of drug use, the legal response to it, and its impact on society, the debate focuses on ideological issues of morality and the rejection of illicit drugs, as data on the prevalence of drug use and the patterns of the use in these countries are missing.

The Maghreb is also part of the MENA region (Middle East and North Africa), which is one of the two regions in the world in which new HIV infections are increasing (with Eastern Europe and Central Asia) and largely driven by drug injection. In 2014, the region has seen HIV infections related to drug injection represent 28% of all new infections, and this represents a minimum since it is based only on often incomplete data submitted by governments. The region is also home to an estimated 630,000 people who inject drugs. This blog will analyze the current situation in two major countries of the region, Algeria and Morocco, which have chosen different approaches to drugs, and compare the outcomes of their policy choices. The blog will finally highlight the current drug policy reform discussions in both countries.

The current official drug prevalence:

Morocco is the country with the most widely available data in the region, with an estimated injecting population of 3000 to 4000 according to the Ministry of Health. Drug injection is concentrated in the North and East of the country, in the transit regions that export cannabis to Algeria and Spain, and import amphetamines (mainly from Algeria) and heroin (mainly from Spain). The country is also the first Arab country, and the second in Africa, to have introduced methadone substitution therapy in six centers in 2011. Furthermore, it is among the two only countries that have a national harm reduction policy in the Arab world, the other being Lebanon. The prevalence of HIV in the general population is of 0.14% (0.1%-0.2%), and mainly concentrated among key affected populations, with people who inject drugs (PWID) representing 10.17% of this total. The country has introduced methadone therapy in prisons as a pilot project , but the author has been informed that the experiment will be extended to five penitentiary centers throughout the country in the coming months.

In Algeria, the situation of PWID or people who use drugs without injection is undocumented. There is no official data on the prevalence of drug use in the country, but it is known that cannabis is the most widely used substance in the country and its use has doubled in the course of two years, between 2012 and 2014. PWID living with HIV represents 1.1% of those tested in 2014, for a prevalence rate among the general population of less than 0.1%. In 2014, a study by the National Office on Drugs and Addiction (Office national de lutte contre la drogue et la toxicomanie) showed that the number of people who use drugs (PWUD) is 250.000, while simultaneously independent research by the FOREM (Fondation nationale pour la promotion de la santé et le développement de la recherché), a non-governmental organization, estimated PWUD to be one million people in the country. A 2006 study on the number of PWID in developing countries reveals that Algeria is the second highest burden country in all North Africa following Egypt, with a number of PWID reaching 40,961.

The two neighboring countries, the largest demographically in the region, hegemons politically and dynamic economically, are at odds largely due to their conflict on the Western Sahara, Morocco claiming its territorial integrity includes the said territory, while Algeria hosts and supports, diplomatically and financially, the separatists. The conflicting relationship between the two countries is also represented in the cooperation against drug trafficking, where they accuse each other of knowingly enriching their respective black markets of illicit drugs. Publicly and through official press conferences, Algeria accuses Morocco of the impact of the large amounts of cannabis being smuggled by the Rif traffickers, while Morocco reminds Algeria that it is one of the largest producers of psychotropic substances that flood the Moroccan black market.

The narcotic laws and drug use:

The laws in Algeria and Morocco punishing drug use and possession are harsh, as they are in the rest of the African and MENA regions. The Algerian law (Law No. 04-18 of 25 December 2004) imposes incarceration between two months to two years in addition to a fine from five to fifty thousand Dinars (fifty to five hundred US dollars) or one of the two sentences for personal use or possession. For a similar offence, a Moroccan convict will face imprisonment of between two months and one year in addition to a fine (Dahir No. 1-73-282 of 21 May 1974), or one of the two sentences. Meanwhile, the Moroccan law remains the least harsh policy in the region. In 2014, 31% of the cases treated by tribunals in the country were related to illicit drugs.

The Algerian narcotics law differs highly from its Moroccan counterpart since it gives precedence to prevention over punishment, as it states preventive and treatment measures before penal judgments. It makes treatment the basis of the legal response to drug use, and sanctions are not enforced if and until the treatment is refused. In addition, returning to treatment when necessary is not prevented even in cases where the treatment decision was previously refused (Article 9 of the law). Sanctions on drug consumption have been reduced for the following reasons: First, punishment for possession or consumption would be imprisonment of between two months and two years. This is a lighter sentence than lockup or hard labor and indicates that drug consumption or possession for personal consumption is considered a misdemeanor rather than a felony; second, the law authorizes the judge to choose between imprisonment and a fine and does not force him to combine the two and third, the judge’s authority to determine the sanction provides some autonomy as to whether imprisonment or a fine is chosen, as there are large differences between the minimum and the maximum limits.

These parameters of the law, that are presented as a prioritization of public health over punishment in drug policy, are still problematic as they allow for the institutionalization of mandatory treatment. According to Article 7 of the law, the examining magistrate or juvenile judge may order detoxification, accompanied by medical surveillance and rehabilitation for “any drug user whose condition requires these measures”. The court’s judicial authority, in this case the specialized judicial authority, may also rule exemption from sanctions (Article 8). According to Article 9, incarceration and fines shall only be applied to anyone who refrains from executing the decision to undergo detoxification. The law as it is today gives judges the power to decide on medical conditions and how they should be treated. Despite every effort, it is still difficult to find data on how many people are diverted from tribunals to treatment centers in both countries.

The findings of on-the-ground research:

To face this complex situation, in countries that produce large quantities of illicit drugs, consume heavily and carry the burden of epidemics related to drug injection, non-governmental organizations on the ground have started researching the situation and gathering evidence. The Association de Lutte contre le Sida (ALCS) in Morocco has launched on-the-ground research as early as 1996 in the Northern provinces of the country to map the injection drug use, and respond to the HIV situation. At the time, drug injection has been found to be limited. A 2003 national survey on mental health and addiction, with a sample of 6000 people over 15 years old, has shown that cannabis is the most widely used substance with a prevalence rate of 3.94%, the age of first use was decreasing, and the prevalence of heroin was of 0.02%. In 2006, with the changing nature of drug use and the spread of HIV through drug injection as transmission mode, the Ministry of Health launched situational studies on drug injection, in order to establish the first harm reduction national plan. The first action was to launch needle and syringe programmes, followed by methadone treatment. The harm reduction programme includes several advances, such as the inclusion of civil society in the delivery of services, the dispensing of harm reduction training, and the delivery of services during the night hours. For instance, the ALCS delivers through its mobile unit a needle exchange programme in three cities in the Rif. Nevertheless, the programme faces tremendous challenges, be it within the harsh legal environment or through the obstacles for the scaling up the services delivery.

In Algeria, and as stated earlier, data and monitoring of current drug policies is missing. The Association de Protection Contre le Sida (APCS) has reached out to the Moroccan ALCS to conduct a rapid diagnostic mission to map the drug situation in the capital city Algiers. For this research, 43 PWUD were interviewed, of which 5 were women, 62% were students or unemployed at the time of the qualitative interview, and represented 6 communes of the capital city. The findings concluded that outside of the squats in the Blida neighborhood, drug injection remains a personal activity, that it concerns all ages and all socio-professional categories of society. Regarding PWID, 70% injected Subutex (buprenorphine) and 30% heroin, and poly-consumption was the most shared behavior of the study participants (100%). 33% of those interviewed were incarcerated at some point in their lives, and up to 5 times for some, and for over 25% the imprisonment resulted of a simple possession offence. The study finally has shown that PWID do not access the services they need, since pharmacists refuse to sell them clean syringes, increase substantially their price, or do not have a stock in remote areas. Finally, only the national hospital of Blida offers rehabilitation and abstinence based programmes which are limited in number and do not respond to the needs of PWID.

This first study highlights the situation in Algiers, and is being currently used to advocate for drug policy and harm reduction reform with the Algerian authorities and civil society. In a consultation entitled “the role of civil society in harm reduction” held in Algiers on September 26-27, 2016 attended by the author, the representative of the Office national de lutte contre la drogue et la toxicomanie, the drug control organ under the chairmanship of the Prime Minister, announced that the country will open the first methadone induction service in Algiers in the coming months. No details were given. Moreover, NGOs collaboration between the two countries is in vivid contrast with the non-cooperation of the states on the drugs issue.

Conclusion:

Algeria and Morocco share the same languages (Berber and Arabic), similar colonial historical patterns, and the longest border for both countries. They also share the drug production, use and trafficking since they both produce large amounts of plant-based (Morocco) or manufactured (Algeria) illicit drugs; they share the same trafficking routes from the Sahara or from the Middle East towards Europe; and cannabis is the most used substance in both countries. Nevertheless, the countries have taken different public policies to respond to drugs. Morocco, a traditional and large producer of cannabis, faced with a heroin crisis in the 2000s developed the first harm reduction strategy in North Africa. Algeria, where heroin injection has not been seen as a health crisis until recently, has focused its efforts on the rehabilitation of PWUD.

khalid_blog-maghreb-drug-policy_finalAfter years of designing drug policies, mainly focused on eliminating drugs and curbing the HIV infections among PWID, drug policy reform is becoming a mainstream discussion in Morocco. The political parties PAM and Al Istiqlal have introduced parliamentary bills to legalize the medical and industrial use of cannabiskhalid_blog-maghreb-drug-policy_final. In Algeria, the debate still focuses on the issues related to trafficking and illicit production, and the announcement of a methadone service has been recurrent since 2015 without details on the location or the conditions required to enroll PWID in need of this service.

View From the Ground: Bocas del Toro; Drugs in Paradise

By Alastair Smith, Panama

Following exploratory fieldwork in the rural coca growing fields of Colombia, GDPO followed the cocaine supply chain to Panama. Most recently, time spent on the Northern Caribbean coast soon revealed the permeation of drug trafficking into the already complex socioeconomic context that many perceive as paradise.

Paradise

Paradise of Bocas del Toro (MandingA 2013)

First impressions of Bocas del Toro – the name of both the 7,000+ person settlement on Isla Colon, just off the north eastern seaboard of Panama, but also the wider surrounding Province – largely confirm its international reputation as an accessible tropical ‘paradise’. With sympathetic afternoon light, the final leg of the 1-hour flight from Panama City reveals aqua marine water lapping at golden sands backed by lush green forests. Once established in the area, other widely talked about attractions of Bocas quickly emerge. There is a wealth of outdoor activities. Many international tourists, largely backpackers, and domestic visitors come to enjoy the Caribbean Sea: to scuba dive and snorkel, surf the notorious waves of Playa Bluff, or to take things a little easier with sunbathing and guided tours to spot the charismatic wildlife.

Party goers in one of Bocas' bars open late into the morning

Party goers in one of Bocas’ bars open late into the morning (Taken by Author 2015)

Another attraction of Bocas del Toro for many, and particularly backpackers, is undoubtedly the opportunity to mix Salsa and Reggaeton music, with low cost national beers and regional rum cocktails, as they enjoy the party life offer on Isla Colon (primarily in BocasTown) and the surround islands. Many of the bars and clubs in Bocas town are right on the water: making it very possible to ‘live the dream’ of enjoying beers in a hammock, dancing off the alcohol, and when things get a little too hot back-flipping off the dock into the cooling sea.

In this hedonistic environment, it is seemingly easy to forget the volumes of boat traffic and not think about the dubious quality of the sea water while enjoying a midnight swim. Another undercurrent in the town is the availability cocaine and cannabis. Sellers freely mix in the nightlife with various degrees of subtly in communicating their offerings. During the day, it is unusual to walk the length of town without being offered ‘weed’ – sometimes as a follow up to the initial list proposal of taking a boat tours to the beach – although there is little menacing about time spent in Bocas, and disinterest is well-accepted by opportunistic sellers.

Part of the reason for the level of supply is the demand of international tourists and more permanent life style migrants willing to pay higher prices than local consumers. However, Bocas del Toro is also well supplied with drugs as one of the recognized points of refuge for traffickers making the journey up the EasternCoast from Colombia to North America

Originally founded as a settlement of concentrated population by foreign banana producers, the region remained disconnected from administration in Panama City due to a lack of a reliable road connection: and therefore, the centralized government administration has lacked a presence in many respects. The archipelago is also composed of some highly remote islands that fall well beyond almost all government services and authority: and as in many cases across the world, the lack of state institutions supports the trafficking of drugs.

IMG_3880

View of coastal geography from the air (Author 2015)

Despite limited resources, local law enforcement officers in Bocas confirm that they have been involved in interdiction operations in partnership with central authorities and the US Coast Guard: furthermore, these operations have yielded high powerboats used by the traffickers that are then repurposed for local counter narcotics operations. Discussions with the local police support existing knowledge that traffickers use the inland water ways of the Panamanian coast to evade the authorities during the day, and then make their staged journeys under the cover of night (UNODC 2012). In some cases it is believed that small shipments of drugs are consolidated in Panama before being moved on (UNODC 2012). Local testimony also identified that during chases, traffickers will jettison quantities of drugs in attempts to bribe the police.

It is through a combination of these mechanisms that trafficked drugs enter the Bocas economy. The availability of drugs then provides relatively easy returns for those willing to become involved. This option is especially attractive so some due to the poor quality of education, high levels of poverty and general limitations on livelihood opportunities in the Bocas region. Despite Panama’s average national economic growth of 7.2% between 2001 and 2013, of the mainly indigenous population of the Bocas del Toro province, 25% are classified as poor and 11% as extremely poor (Omar and Moreno 2014). Many of these people live on subsistence agriculture and fishing on outer islands. There is therefore a potentially strong pull incentive to become involved in the distribution of drugs. In this case, as was found in Colombia, rural development will likely be as important an anti-trafficing policy as strengthening governance capacity for interdiction operations.

In conclusion, while the vast majority of visitors to Bocas del Toro find their expectations of fulfilled, the reality is that the international trafficking of drugs is playing into a complex socioeconomic situation, which many of the ‘poor’ permanent residents might well not accept as ‘paradise’. Again, genuine investment in enhancing the life opportunities of those currently motivated to support drugs distribution will likely contribute to a reduction in the global trade in narcotic drugs.

Sources

Omar, A. and V. Moreno ( 2014). Pobreza e Indigencia. Panama, Ministerio de Economia y Finanzas.

UNODC (2012). Cocaine from South America to the United States. Transnational Organized Crime in Central America and the Caribbean A Threat Assessment. Vienna, United Nation Office on Drugs and Crime.

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Ketamine under international law

This blog was originally posted here

Psychoactive substances or ‘drugs’, often associated with recreational use, are in fact commonly used for a variety of medicinal purposes. It is even less understood that the supply of more than 100 of these drugs is regulated by a complex system of international drug control underpinned by three United Nations treaties with near universal ratification. This post explores the relationship of drugs and international law, specifically international drug control law and international human rights law, using the topical example of placing ketamine under international control.

International drug control law

The legal framework of international drug control is shaped by three treaties: the 1961 Single Convention on Narcotic Drugs (as amended by the 1972 Protocol), the 1971 Convention on Psychotropic Substances, and the 1988 Convention against the Illicit Traffic in Narcotic or Psychotropic Substances. Scheduling is the process established by the treaties to bring certain psychoactive substances under a graded scale of international control. Scheduling a substance creates positive obligations for States to implement regulatory processes that meet or exceed requirements established by the treaties. In some overburdened health systems, this can lead to over-restrictive controls that inhibit medical access to essential drugs, well documented in the case of opioid analgesics.

Uses of ketamine

Ketamine’s unique properties make it one of the most important and widely used drugsin emergency and surgical medicine globally.   Where most anaesthetics require electricity for ventilators and gas masks, ketamine—an injectable anaesthetic—can be safely administered in settings without regular access to power, for example, war zones or impoverished rural areas. The analgesic properties of ketamine make its use during emergency surgery, such as for caesarean sections, indispensible for improving mortality outcomes in less-developed countries throughout the Global South. It is because of these properties that the World Health Organisation (WHO) placed ketamine on its list of essential medicines for both children and adults.

Outside of clinical settings, ketamine is used recreationally, although such use is mainly in more developed countries. China, in particular, views the illicit production of ketamine as an “increasingly serious” domestic issue and has repeatedly requested the substance be subject to international control. It is with this direction from China, that ketamine has made its foray onto the international legal stage.

Scheduling ketamine under international law

Established in 1946 by ECOSOC, the Commission on Narcotic Drugs (CND) serves as the principal policy-making body of the UN drug control system and under the three drug control treaties, it is mandated to oversee the scheduling system. China is currently one of 53 members of the CND, and is authorised under the treaties—in the case of ketamine, the 1971 Convention on Psychotropic Substances—to introduce substances of concern for scheduling consideration.  Procedurally, article 2 of the 1971 Convention requires the CND to submit scheduling recommendations to the World Health Organisation (WHO) for an evidence-based review to determine if the substance meets the criteria elaborated under article 2(4) to require scheduling (or not) and its degree of restriction under the graded scheduling system. Under article 2(5) of the 1971 Convention, the WHO’s recommendations are “determinative” when it comes to the “medical and scientific” basis for adding substances to a schedule.

This is not the first time China has requested ketamine be scheduled. The WHO’s review this year and each time before (see here and here) determined the public health risks associated with recreational use did not merit any measure of scheduling. The conclusive nature of this recommendation under the 1971 Convention has been subject to much interpretative debate. The current prevailing interpretation has placed the status of such a recommendation within broader considerations such as “economic, social, legal, [and] administrative” factors listed in article 2(5).

What this interpretation signals is that despite WHO’s determinative assessment that ketamine does not meet the criteria for scheduling under article 2(4), its scheduling may now be subject to a purely political process (a two-thirds vote by the CND would place ketamine under international control).

The control of ketamine and international human rights law

The impact the control of ketamine has upon human rights is a critical consideration. While human rights are not explicitly mentioned in the 1971 Convention, they are contained within the meaning of “legal” considerations as written in article 2(5), which States must take into account when deciding to add a substance to a schedule.

As mentioned previously, scheduling a substance creates regulatory barriers that have made essential medicines completely inaccessible for those most in need. These barriers result in on-going violations of human rights—most notably the right to health. The normative scope and content of the right is contained within article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) and imposes upon States core obligations to be given immediate effect. General Comment 14 on the right to health elaborates further that amongst this minimum core is the obligation to provide medicines as indicated on the WHO’s essential medicines list. As such, ensuring ketamine is available, accessible, acceptable, and of sufficient quality forms part of a State’s core right to health obligations.

Should ketamine fall under the scope of international control, any restrictive measures a State subsequently imposes cannot interfere with current levels of access. The imposition of international control requirements would in many States, restrict current levels of access to ketamine and amount to a deliberate retrogressive action in violation of the right to health. This is relevant to any scheduling level under the 1971 Convention. While Schedule 1 imposes the most restrictive control measures, States can apply equally or more restrictive measures for any schedule level under article 23. As such, the same human rights assessment would apply as States with less complex regulatory systems often lump controls into one or two highly restrictive categories—see the example of phenobarbital, a Schedule 4 drug under the 1971 Convention.

As the vote fast approaches, a human rights framework offers States a powerfulnormative counterweight to the political pressure they face to place ketamine—an essential, life-saving medicine—under unnecessary international control.

Visit the International Centre on Human Rights and Drug Policy for more resources.

Daily updates from the CND can be found here.

The ketamine controversy, continued

This blog was originally posted here

UN legal opinion adds confusion while China changes its scheduling proposal

Friday, March 6, 2015

The Commission on Narcotic Drugs (CND) in Vienna will decide next week between two opposite proposals by China and the WHO about international control ofketamine, an essential anaesthetic in human and veterinary medicine. China originally proposed bringing ketamine under the 1971 Convention’s most severe control regime of Schedule I, which would dramatically affect its availability for surgery in poor rural settings and emergency situations. The WHO Expert Committee reviewed all the evidence and advised against any international control of ketamine, arguing it would trigger a public health disaster.

fact sheet produced by concerned NGOs, TNI among them, has received endorsements from over 80 organisations around the world, including many medical associations of anaesthesiologists and palliative care. The International Federation of Red Cross and Red Crescent Societies came out with its own statement of concern. At intersessional CND meetings past weeks in Vienna, several countries expressed their worry about the Chinese proposal and questioned the procedural legality of bringing it to a vote, now that the WHO has strongly recommended against it. Confronted with broad opposition, China changed it proposal and now calls for inclusion in Schedule IV instead, the lightest control regime under the 1971 Convention. The move is meant to soothe concerns and apparently several countries that opposed China’s original proposal are considering the softer option as an acceptable compromise.

Adding ketamine to Schedule IV, however, would still negatively impact on its availability in a number of countries, less severely so when compared to Schedule I, but millions of people would still be at risk of not having access to anaesthesia if they require surgery (seeextended fact sheet). Moreover, too little attention has been given in the debate so far to the potential consequences for future scheduling decisions, as this would set a precedent to add substances to the treaty schedules bypassing WHO’s expert advice. In response to questions raised about the procedure, UNODC asked the UN Office of Legal Affairs (OLA) in New York for a legal opinion about the basic question: “Can the Commission on Narcotic Drugs schedule a substance under the Convention on Psychotropic Substances of 1971 if there is a recommendation from the World Health Organization that the substance should not be placed under international control?”. Unfortunately, under time pressure, OLA produced an unhelpful, confusing and questionable legal argumentation concluding that “the Commission can schedule a substance under the Convention on Psychotropic Substances even if there is a recommendation from WHO that the substance should not be placed under international control” (E/CN.7/2015/14).

The 1971 treaty – as explained in detail in its Commentary – established a threshold for substances to be eligible for international control, which requires a careful weighing of their addictive and harmful properties against their medicinal usefulness. The review of the WHO Expert Committee on Drug Dependence is “determinative” regarding medical and scientific matters whether or not a substance meets that threshold. Once the WHO has determined that a substance meets those minimum criteria warranting international control, the CND can discuss the WHO recommendation and consider additional arguments (“economic, social, legal, administrative and other factors it may consider relevant”) to either adopt, reject or deviate from the choice for the particular Schedule recommended by the WHO. As spelled out in the Commentary on the 1971 Convention, if the WHO “recommends in its communication to the Commission that the substance should not be controlled, the Commission would not be authorized to place it under control” (§ 22, p. 71). Clear and simple, it seems, but apparently not for the Office on Legal Affairs.

In its legal opinion, OLA acknowledges that “WHO assessments are determinative as to medical and scientific matters of a substance,” but then continues saying: “but the ultimate authority to decide whether the substance should be added in a Schedule rests with the Commission. In doing so, the Commission is required to take into account factors broader than medical and scientific factors.” The CND “is expected to take a broader perspective, and is required to take into account all relevant factors to reach a conclusion.” On those grounds OLA then reaches its controversial conclusion quoted above, contradicting the official Commentary, and clearing the path – though the OLA advice is not binding in any way – for bringing China’s proposal for scheduling to a CND vote next week. Two-thirds of the 53 CND Member States would need to vote in favour to adopt it, in other words if 18 countries vote against it or abstain from voting the proposal would be rejected.

Following OLA’s treaty interpretation means that the other factors that the CND needs to consider (economic, social, legal, administrative) may provide sufficient reason for adding a substance to a treaty schedule, including if the substance does not meet the required threshold of dependence-producing and harmful properties. The OLA opinion confuses the clear intention of the treaty to establish a minimum threshold to be determined on the basis of medical/scientific evidence by the WHO, with the subsequent discretion of the CND to deviate from WHO’s specific recommendation about which schedule would be most appropriate, after taking into consideration other factors. It is difficult to understand how OLA arrived at such a fundamentally flawed judgement.

OLA also looked into the scheduling history to determine whether there have been any precedents for the situation the CND is confronted with now in the case of ketamine. Two previous cases, in 1991 and 1999, were identified as possibly relevant cases to consider. After acknowledging their different nature compared to the question at hand and that “these two cases seem to indicate that the Commission has generally followed WHO recommendations”, OLA then concludes in what again appears to be a difficult-to-follow twist of the argument that “the practice of the Commission to reject WHO recommendations is still relevant as it indicates that the Commission has not felt itself bound by WHO recommendations.” For the matter under consideration not only a confusing but also an irrelevant remark, because nobody questions that the CND has considerable discretion under the 1971 Convention (more than allowed under the 1961 Convention) to deviate from WHO scheduling recommendations. The treaty and the Commentary make very clear that indeed, the CND is not “bound by WHO recommendations”. The one thing the CND is not allowed to do, however, is scheduling a substance that the WHO has reviewed and concluded that it does not meet the threshold that warrants international control. In the case of ketamine, the WHO has reviewed and decided that three times now…

In one of the previous cases the OLA refers to, arguments were raised in the procedure that could in fact be relevant for the current situation. In short, Spain, worried over the amount of new psychoactive substances appearing on the market, tabled in 1999 a proposal to add all isomers, esters and ethers of substances already on Schedule I or II, placing all such chemically similar substances under the same control. The WHO reviewed the Spanish proposal, and recommended instead to only add substances falling under the much narrower definition of “stereoisomers” and only for Schedule I. The CND adopted by vote the WHO recommendation, and according to the OLA document “there is no record of any action taken with respect to the substances to which WHO objected”. And indeed, correctly following treaty procedures no vote was taken on the Spanish proposal because that included a much broader range of substances that the WHO had not recommended for international control.

The Netherlands argued at the time that the 1971 Convention “prescribes that new substances should first be carefully examined by WHO and then could be added to one of four Schedules if deemed necessary” and that the Spanish proposal therefore “may contradict the scheduling procedure”. The Netherlands “attaches great importance to a balanced and thorough expert opinion on health and social risks created by new substances before they are included in a schedule. As indicated above, WHO is required by the Convention to examine and evaluate each individual substance. Applying unconditional analogue scheduling would, however, substantially diminish the importance of this WHO task. In the opinion of the Netherlands, this would be a loss of expertise and negatively affect the scientific basis of the decision-making process within the Commission on Narcotic Drugs.”

As the OLA opinion confirms (in spite of its confused wording), there is not a single precedent in the history of scheduling decisions under the 1971 Convention where the CND decided to schedule a substance that had not been recommended for scheduling by the WHO. If the CND would decide to vote on the Chinese proposal to schedule ketamine, despite the fact that the WHO has already determined three times that it does not meet the threshold criteria for international control, it would therefore set a very worrying precedent. It effectively means the removal of the medical/scientific threshold for international control and abolishing the determinative nature of the mandate given to the WHO. The consequence of that for the future would be that any CND Member State from now on can call for a vote to put any substance on whatever schedule of the 1971 Convention (under the 1961 Convention this would be unthinkable), regardless of the opinion of the WHO Expert Committee. Tramadol and khat would be likely candidates to become scheduled in the coming years in a similar way, using the ketamine precedent to justify neglecting WHO’s expert advice again.

The OLA opinion was accompanied by a disclaimer saying that countries and the CND “may take a different view to the responses we provide. As such, our response should not in any way be construed as the only or definitive view.” Countries should critically examine OLA’s legal opinion and carefully consider its consequences for the future functioning of the UN drug control treaty system. Allowing the CND to vote about the scheduling of ketamine contrary to WHO’s recommendation, makes a mockery of the evidence-based intentions of the treaties and politicizes scheduling decisions in the future. Countries that are genuine in their calls for a more health- and human rights-based drug control system, for improving access and availability of essential medicines and for a more evidence-driven drug policy making, cannot allow this to happen…

See also my previous blog: “CND decision to schedule ketamine would undermine WHO treaty mandate”, 16 February 2015

World Medical Association warns against making essential anaesthetic a controlled drug, WMA press release, March 6, 2015

CND decision to schedule ketamine would undermine WHO treaty mandate

This blog was first posted here

The UN Commission considers to bring ketamine under the control of the 1971 Convention on Psychotropic Substances contrary to WHO recommendations
Monday, February 16, 2015

The 58th Session of the UN Commission on Narcotic Drugs (CND) in March 2015 has been asked to consider a Chinese proposal to place ketamine – an essential medicine used for anaesthesia – in Schedule I of the 1971 Convention (E/CN.7/2015/7 and E/CN.7/2015/81). Ketamine is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine under any of the 1971 treaty schedules will reduce its availability and further deepen the already acute crisis of global surgery.

The WHO has strongly and repeatedly recommended against international control, warning it would constitute a public health crisis in countries where no alternatives are available. The CND is taking place in Vienna on 9-17 March 2015.

> See also: Fact Sheet on the Proposal to Discuss International Scheduling of Ketamine at the 58th CND

On the UNODC website, in the CND section, appears a page under the title “Scheduling procedures” containing incomplete – and therefore misleading – information with regard to the options available to the CND in the case of a decision on ketamine. It says that the Commission “may decide – contrary to a recommendation of WHO – to add a substance to a schedule of the 1971 Convention or refuse to do so, to add a substance to a different schedule than recommended, or to remove a substance from the schedule in which it is listed or refuse to do so. However, the CND has to take into account the assessment from the WHO, which shall be determinative as to medical and scientific matters, and to bear in mind the economic, social, legal, administrative and other factors communicated to it by the Parties.”[1]

The footnote to the paragraph references the Commentary on the 1971 Convention [2], which indeed talks about the Commission’s “very wide discretionary powers” but it adds that this “does not mean that it may act arbitrarily”. [3] The key procedural question on the table in the case of ketamine is whether the CND “may decide – contrary to a recommendation of WHO – to add a substance to a schedule of the 1971 Convention”, a correct direct quote from the Commentary. [4] However, the Commentary also specifies that “there are cases in which the Commission would be bound to act in accordance with recommendations of WHO”, cases that unequivocally apply to the current case of ketamine:

commentary-1971-par22

The WHO Expert Committee in its latest review clearly established that “ketamine abuse currently does not appear to pose a sufficient public-health risk of global scale to warrant scheduling. Consequently, the Committee recommended that ketamine not be placed under international control at this time.” [5] According to the Commentary quote above, that means that “the Commission would not be authorized to place it under control.”

Moreover, the Commentary also mentions specific restrictions on the CND to decide about adding substances to Schedule I:

commentary-1971-par24

Again, the WHO Expert Committee is very clear on that issue:

“Ketamine is included in the WHO Model List of essential medicines and the WHO Model List of essential medicines for children as well as in many national lists of essential medicines. Ketamine has analgesic, hypnotic and short-term memory loss (amnesic) effects and is useful for induction of anaesthesia, procedural sedation and analgesia. Compelling evidence was presented about the prominent place of ketamine as an anaesthetic in developing countries and crisis situations. The ease of parenteral administration gives ketamine a major advantage when anaesthetic gases are impossible to use owing to limited equipment and a lack of appropriately trained specialists.”[6]

According to the Commentary quote above, this means that the CND cannot decide to place ketamine in Schedule I. This renders the Chinese proposal to include ketamine in Schedule I invalid under the terms of the treaty, thereby ruling out the option of calling for a vote on the proposal. Also the note prepared by the Secretariat on “Changes in the scope of control of substances”, is confusing and misleading. After describing the Chinese proposal, under the heading “Action to be taken by the Commission on Narcotic Drugs” the note explains the voting procedure specifying that a decision requires a two-thirds majority, concluding:

“The Commission should therefore decide whether it wishes to place ketamine under Schedule I of the 1971 Convention or, if not, what other action, if any, might be required.”[7]

The Secretariat does not point out the obvious contradiction with the WHO recommendation (which is only included in the note as an annex) and the procedural limitations the WHO conclusion places on the nature of the decision the CND can make. Instead, the issue is presented under the title “Consideration of a notification from China concerning the proposed recommendation for international control of ketamine under the Convention on Psychotropic Substances of 1971” and the note implies that the normal action to take would be to call for a vote. The WHO recommendation not to place ketamine under international control is only included as an annex.

Conclusion

Both the UNODC website text and the note by the secretariat give the misleading impression that the CND has full discretion to decide against the WHO recommendation and that the procedurally normal course of action would be for CND Member States to vote on the Chinese proposal. Under the terms of the 1971 Convention, as clearly explained in the Commentary, neither is correct. While the CND does have more discretionary powers in scheduling decisions under the 1971 Convention compared to the 1961 Single Convention, there are clearly established restrictions how far a CND decision can deviate from the WHO recommendations. Those restrictions fully apply in the case of ketamine and exclude the option for the CND to place ketamine under international control. The WHO review outcomes have rendered the Chinese proposal for scheduling invalid under the terms of the 1971 Convention.

The importance of following the proper procedure of scheduling in the international drug control system goes much further than the urgency right now to prevent the public health disaster that would be triggered by scheduling ketamine. Allowing this procedure to proceed unquestioned would set a dangerous precedent for scheduling other substances such astramadol and khat in the future in a similar way bypassing WHO advice. It would once again marginalize the role of the WHO in the UN drug control system and undermine the specific treaty mandate given to the WHO Expert Committee to provide an evidence base to scheduling decisions. It would be yet another example that the original treaty balance between assuring adequate access of controlled substances for medicinal purposes while preventing diversion and abuse, has been lost. It is also a good litmus test for the welcome but often vague discourse of shifting towards a health and human rights-based drug control approach. Keeping ketamine out of the treaty schedules is a good example of what taking that discourse serious means in practice.


[1] Scheduling procedures, UNODC web page (visited 8 February 2015), first paragraph 11 (there are two).

[2] Article 2(4)-2(6), 1971 Convention. See also the Commentary on the Convention on Psychotropic Substances , pp. 45-72.

[3] Paragraph 19, p. 70.

[4] Paragraph 20, p. 71.

[5] WHO Expert Committee on Drug Dependence: thirty-sixth report, WHO technical report series no. 991, 2015, p. 45.

[6] Ibidem.

[7] E/CN.7/2015/7, Changes in the scope of control of substances, Note by the Secretariat, p. 10.

Has the US just called for unilateral interpretation of multilateral obligations?

by Rick Lines And Damon Barrett

[Dr Rick Lines and Damon Barrett are the Chair and Director of the International Centre on Human Rights and Drug Policy, University of Essex]

This post was originally published here

These are interesting times for drug law reform, which, as it gathers pace, is asking important questions of international law. A UN General Assembly Special Session on Drugs is set for 2016just as national reforms are challenging international treaties that form the bedrock of a global prohibition regime that has dominated since the turn of the twentieth century. States parties to the three UN drug control conventions must now confront the legal and political dilemmas this creates. This is the situation in which the US now finds itself following cannabis reforms in various states that are at odds with these treaties. The State Department has issued its official position in this regard, one that stretches and boundaries of interpretation and raises other serious questions for international law.

In an October statement Ambassador William Brownfield set out that position in the form of the ‘four pillar’ approach the United States will now follow in matters of international drug control. While the four pillars, set out below, have prompted much discussion and debate among those working on drug policy issues, attention among international lawyers has been rare. This is something of an important gap given the implications of what the US suggests:

  1. Respect the integrity of the existing UN drug control conventions.
  2. Accept flexible interpretation of those conventions.
  3. Tolerate different national drug policies…[and] accept the fact that some countries will have very strict drug approaches; other countries will legalise entire categories of drugs.
  4. Combat and resist criminal organisations, rather than punishing individual drug users

Internationally, the four pillars have emerged in the context of efforts, led primarily by Latin American States, to open discussions on the future of the international drug control regime, and look at alternatives to the current and destructive prohibitionist paradigm.  Domestically, it comes in the context of successful referenda to legally regulate cannabis in several US states.

Both of these are welcome developments. The international drug regime is long overdue for reform, and the cannabis referenda will produce many positive criminal justice, health and social outcomes in those US states adopting them. However, domestic cannabis law reform places the United States in a compromised position within the coming debates on the future shape of the international drug control regime.

By permitting legal markets in recreational cannabis, the United States is in breach of both the 1961 Single Convention on Narcotic Drugs and the 1988 Convention on Illicit Traffic in Narcotic Drugs and Psychotropic Substances. This is an awkward position for the US, which for over 100 years has been both the driving force behind the international drug control regime, as well the regime’s de facto policeman. Admitting the breach threatens both a system the US wishes to protect, as well as its own influential role within it. Rectifying the breach domestically requires trampling on State-level democratic ballot initiatives. To its credit the Obama Administration has said via a memorandum from Deputy Attorney General James Cole it will respect and not interfere with the outcomes of those referenda.

The four pillars are a response to this legal and diplomatic conundrum. To justify its contention of treaty ‘flexibility’ – allowing, for example, its legal cannabis market – the US engages in some interesting, if problematic, legal gymnastics. As explained in an earlier speech of Brownfield’s in March:

[I]f it is a living document and they are living documents [the UN drug control conventions], living means you are allowed to adjust your interpretation as the world changes around you, the world in 1961 was a different place from the world in 2014 and we the governments and members states of the UN system should be permitted to interpret with that degree of flexibility as we move in to the 21st century.

Using the language of treaties as living documents – more commonly known as dynamic or evolutive interpretation – Brownfield attempts to paint cannabis legalisation in the US as something other than the breach it obviously is, in the process raising a number of international legal concerns.

Dynamic interpretation is well established in international human rights law, particularly the jurisprudence of the European Court of Human Rights. But, as described by the International Law Commission in 2006, it is an approach ‘much more deeply embedded in human rights law than in general international law’, suggesting that its application in the context of international drug control law must be considered cautiously. This is not to suggest that dynamic interpretation is not evident in other regimes, and it indeed has been used by the International Court of Justice, the European Court of Justice and the Appellate Body of the World Trade Organization in various cases.

The drug treaties are suppression conventions. They form part of the body of transnational criminal law, not international human rights law. However, we accept that, for a variety of reasons it is legitimate to apply a dynamic interpretive approach to elements of international drug control law, particularly where drug control engages human rights. However, there are clear problems with the US’s use of this approach.

The first is the limits of interpretation itself. The classic approach to dynamic interpretation, as established by the European Court in Tyrer v UK, is a process of broadening or expanding the understanding of an obligation based upon changes in law, evolving social norms or widespread change in State practice. In other words, understanding treaty language in a modern context. There are various examples of this in practice from differing legal regimes.

However, Brownfield suggests that the ‘living’ nature of the drug treaties means that an obligation can legitimately evolve to the point of meaning the exact opposite of what it states, and that somehow the non-medical, non-scientific use of cannabis has evolved from being illegal in international law to being legal. This is an absurdity. The treaties already include a mechanism for the status of individual drugs to change or evolve, and for individual substances can be included in, or removed from, international control with approval of the UN Commission on Narcotic Drugs, a process known as ‘rescheduling’. The Brownfield approach circumvents this, for the obvious reason that such a resolution would never make it through the Commission, and instead posits the ‘living instrument’ idea as the alternative.

However, for this outcome to be legally valid without cannabis being rescheduled, dynamic interpretation would need to alter the understanding of what the term ‘medical and scientific use’ means within the conventions, the only circumstance within the current international regime under which cannabis, and all controlled substances, may be legally manufactured, accessed and used. But Brownfield does not suggest this, for if he did then this evolved understanding of medical and scientific use could reasonably be applied to all drugs under international control, making legal recreational access to all controlled drugs part of the new ‘living’ drug regime. This is clearly a bridge too far for the US.

The second problem is one of interpretive forum. Dynamic interpretation is a judicial approach, utilised by judges or adjudication bodies to balance competing or conflicting interests in arriving at a decision. It is an approach employed by a neutral arbiter to dispute resolution, not a doctrine for States to use to unilaterally change the nature and scope of their own treaty obligations. Indeed, if we are to pursue an evolutive approach, then we also need to look at broader State practice. You can easily count on the fingers one hand the number of countries with a legalised recreational cannabis market, so this approach has clearly not evolved to an extent where legal regulation of the substances within the treaties would be permissible. Even then it is stretching any reasonable interpretation to reverse what the law in fact says. But in any case Brownfield does not suggest that we look to evolving State practice. The four pillars suggest, quite clearly, the acceptance of divergent unilateral interpretations. Whatever one thinks of the drugs treaties, such an approach creates an international minefield. Imagine an international legal order in which individual States are allowed to decide for themselves which treaty obligations apply to them, and in what way.

Here, however, we come to the third major problem, which is that the flexibility the US seeks for itself may not extend to others at all. We have both argued separately that this new US position has little to do with treaty compliance, and is really about maintaining its own central role as global arbiter of drug control, a position which it uses to great influence internationally. Surprisingly, US drug czar Michael Botticelli recently admitted as much in his Senate confirmation hearings, stating that ‘[t]he Four Pillar framework is an effort to stake out a middle ground between those who believe that prosecution and jail is the only approach and those favoring radical changes to the conventions’. In effect, the US denial of its own treaty breach allows it to sit in judgement over the drug reform actions of other States, comfortable in its self appointed role of neutral ‘middle man’ or ‘referee’ of acceptable treaty flexibility, and therefore protecting its own national interests against any ‘radical changes to the conventions’, apart from its own.

To be clear, our concern is not about compliance with bad laws, which these treaties surely are. Our concern is with the potential implications of the State Department’s argumentation. The failed, punitive prohibitionist approach of the international drug control regime must end. It is a regime that causes untold human and societal damage across the globe, and change to this regime is slow yet becoming more inevitable. However, it would be unfortunate to see established rules of international law become collateral damage in the fallout of the end of the war on drugs.

Fatal attraction: Brownfield’s flexibility doctrine and global drug policy reform

This post was first published here at the Huffington Post

A joint contribution by:

Professor Dave Bewley-Taylor
Director, Global Drug Policy Observatory, Swansea University

Martin Jelsma
Coordinator, Transnational Institute Drugs and Democracy Programme

Damon Barrett
Director, International Centre on Human Rights and Drug Policy

___________________________________

State-level cannabis reforms, which gathered steam this month, have exposed the inability of the United States to abide by the terms of the legal bedrock of the global drug control system; the 1961 Single Convention on Narcotic Drugs. This is something that should force a much-needed conversation about reform to long-standing international agreements. But while ostensibly ‘welcoming’ the international drug policy reform debate, it is a conversation the US federal government actually wishes to avoid. The result is a new official position on the UN drugs treaties that, despite its seductively progressive tone, serves only to sustain the status quo and may cause damage beyond drug policy.

The 1961 Single Convention has been massively influential. Almost every state in the world is bound to prohibit cultivation, trade and possession of cannabis and a range of other substances such as coca and opium for anything but medical and scientific purposes. Wherever you are, your drugs laws are probably modeled on this agreement.

The United States has been a staunch defender of this legal regime. The treaties are central to its foreign policy on drugs, including in Latin America. But at home the government has been clear that it will not trample on the will of voters with regard to cannabis, even though this places it in breach of the 1961 Convention. So the US faces a predicament; a treaty breach it does not wish to admit within a system it wishes to protect.

The response is the new ‘four pillars’ approach, set out by Ambassador William Brownfield (Assistant Secretary of State for International Narcotics and Law Enforcement):

Respect the integrity of the existing UN Drug Control Conventions…

Accept flexible interpretation of those conventions…

Tolerate different national drug policies…accept the fact that some countries will have very strict drug approaches; other countries will legalize entire categories of drugs…

Combat and resist criminal organizations

Brownfield’s statement received some positive responses, welcoming it as a breakthrough in drug policy reform. However, its attractiveness is superficial and there are important reasons to be cautious.

For US foreign policy on drugs the four pillars make sense in the short term. Through these pillars, the US can appear to embrace reform discussions while changing nothing of substance. US approaches to Latin America that have dominated US attentions can carry on as before. The US gets to continue to have presence in places it has no business being other than to fight the drug trade – the fourth pillar of this ‘new’ approach.

In addition, in defending the ‘integrity of the treaties’, the US can go on using those treaties as a disciplinary tool against producer and transit nations in the region. Under the Foreign Relations Authorization Act, when a country does not fulfill the requirements of the international drugs conventions, the President determines that the country has ‘failed demonstrably’ to meet its obligations, which can lead to sanctions.

Bolivia received such a determination again only a few weeks ago. While explaining the rationale for a more ‘flexible interpretation’ Brownfield said, ‘Things have changed since 1961‘. However, the Presidential Determination on Bolivia stressed that the ‘frameworks established by the U.N. conventions are as applicable to the contemporary world as when they were negotiated and signed by the vast majority of U.N. member states‘.

The determination further expressed the US government’s concern that Bolivia tries ‘to limit, redefine, and circumvent the scope and control‘ for coca under the 1961 Convention, even though that is precisely what the US is doing in the case of cannabis.

The US also objected to Bolivia’s efforts to have traditional uses of coca removed from international control because it challenged the ‘integrity of the treaties’ – the very first pillar above. So which countries’ reforms or interpretations will be deemed tolerable, and which will threaten the integrity of the treaties? Crucially, who decides?

It is clear that a legally regulated market in cannabis is not permissible under the 1961 Single Convention. To deal with this the US, in the second pillar above, has signalled its acceptance of unilateral interpretation of multilateral agreements beyond what those agreements allow for. That is a very serious call beyond cannabis and beyond drug policies. The attempt under the Bush administration to argue that waterboardingwas not a breach of the UN Convention Against Torture and that detainees in the war on terror were not covered by the Geneva Conventions should caution against allowing this kind of unilateral approach.

In reality, beyond the progressive sounding words, the path the Brownfield doctrine set out leads to further US exceptionalism and the ongoing use of the treaties as it sees fit.

But that exceptionalism cuts both ways, and the US has also vital interests, including national security, in holding states to international and bilateral treaty obligations. A recent example demonstrates the risks of failing to take this into account. In July, the US issued a determination that Russia was in violation of obligations of the Inter-Range Nuclear Forces Treaty (INF), a bilateral agreement banning the testing of ballistic missiles of a certain range. But if a ‘flexible’, a-la-carte approach is to be permissible under the drug control regime when it suits the US, why should that not apply here?

Why not other important international agreements that matter to so many such asenvironmental protocols setting specific targets, or human rights law and its vital protections? Following the second pillar to the extent the US suggests is a very slippery slope.

The shift to regulated cannabis markets in the US should open the space for a much-needed discussion of treaty reform. The problem at hand is not the treaty breach by the US; the problem is the drug control treaty system itself. Preparations have started for a UN summit on drugs in 2016, the first in almost twenty years, and where a conversation about treaty reform should begin. The Brownfield doctrine is part of US efforts to keep it off the agenda.

For governments, in an effort to avoid political controversy, the four pillars may seem attractive. For those who support drug policy reform they may seem progressive. But this is no win for drug policy reform or progress towards policies grounded in evidence and human rights. To allow the US, for its own ends, to lead us into a politically calculated theatre of adherence simply serves to sustain a regime that is no longer fit for purpose. It is also harmful for the integrity of international law more broadly, from human rights, to security to the environment. The price of allowing the US to avoid its breach of the 1961 Convention, in other words, is too high. And the war on drugs has already cost too much.