Drugs, Prisons and ‘Unintended Consequences’ – Does drug interdiction drive drug-related harms?

Rick Lines, Olivia Howells and Daniel Webb*

The availability of drugs in prisons around the world is well documented. In Europe alone, up to seventy percent of people in prison have used an illicit drug. In Canada, forty-eight percent of prisoners in federal correctional institutions have had ‘problems’ with drugs. In Australia, one in six people discharged reported using illicit drugs during their sentence.

The 2018-19 Annual Report of HM Chief Inspector of Prisons for England and Wales stated, ‘we are regularly told how easy it is to get hold of illicit drugs in prisons, and of the shockingly high numbers who acquire a drug habit while they are detained’. The Chief Inspector was ‘particularly concerned by the high number of prisoners who said they had developed a problem while in prison – 13% of adult men in our survey reported that they had developed a problem with illicit drugs since they had arrived’. Here in Wales, a Cardiff prison survey found that fifty-two percent of prisoners said it was easy to get illegal drugs into the prison.

The availability and use of drugs in prisons cannot be separated from wider drug policy. The criminalisation of drugs and the people who use or sell them fuels mass incarceration in many countries, and in doing so creates large profitable markets for drugs behind bars. To counter this, prison systems around the world have deployed a wide range of supply reduction and drug interdiction measures – from searches to sniffer dogs to drug testing – to try to stop drugs entering prisons, and to disrupt internal markets.

Are these measures effective at deterring drug use or shrinking illicit markets? The high levels of drug use in prison cited above suggest the impacts are limited at best, and that despite the efforts of prison security, drugs continue to flow into places of detention with relative ease.

Although supply reduction efforts in prisons may be ineffective overall at eliminating drug markets, that does not mean they do not have an impact on drug consumption. As noted in 2008 by Antonio Maria Costa, former Executive Director of the UN Office on Drugs and Crime, efforts to control illicit drugs often have negative ‘unintended consequences’ not considered at the time they were implemented. In other words, drug enforcement efforts often have the effect of creating problems worse than those they were intended to solve. In prisons, one of these ‘unintended consequences’ is increased drug-related risk and drug-related harms.

One widely used measure to deter drug use in prisons is mandatory drug testing (MDT). The UK Ministry of Justice states that 67% of prisoners surveyed in 2014/15 had participated in some form of MDT. While the UK government states that MDT is intended to ‘deter prisoners from misusing drugs’ and to ‘contribute to drug supply reduction, and contribute to prisoner safety, violence reduction, order and control’, the evidence suggests that random drug testing may actually undermine all of those objectives.

Cannabis is the most commonly used drug by people in prison in the UK, with a reported 79% lifetime prevalence of use. It is also a drug that remains highly detectable in the body for long periods after use. As such, cannabis users in prison have a ‘high risk of detection through mandatory drug tests’. One of the ‘unintended consequences’ of MDT in prisons is therefore a switch from cannabis use to heroin use among prisoners. As heroin is undetectable via MDT after only two to three days, heroin use becomes a logical choice for people who want to use drugs and minimise their risk of being caught. This switch to heroin use can also lead to a switch from smoking to injecting as a route of administration, with the attendant risks of blood-borne virus transmission and vein damage from sharing and reusing scarce injecting equipment in prisons.

There are also increasing indications that drug interdiction activities in prisons are driving the availability and use of new psychoactive substances (NPS), with mandatory drug testing again playing a role. Many varieties of NPS are not detectable by drug testing, creating an incentive to choose new psychoactives as a way to minimise risk of detection. As noted by one observer, ‘due to testing…cannabis, which is argued to be a lower risk substance, has been replaced by spice – a substance perceived to have more dangerous health implications’. A study commissioned for the National Offender Management Service found that prevalence of synthetic cannabinoids was twice as high among prisoners at time of release than at the time of admission. In that study, synthetic cannabinoids were the only substance for which a higher prevalence was detected upon release than upon admission, suggesting a statistically significant uptake of use of NPS by people in detention.

The European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) has noted that ‘the avoidance of positive drug tests has been suggested as motivation for drug users to switch to NPS while in prison’ and that ‘increases in NPS use in prisons may therefore, arguably, be an unintended negative consequence of random mandatory drug testing programmes in some European prisons’.

While the UK and Germany have recently incorporated detection of synthetic cannabinoids into its MDT programme, this ultimately will not address the issues of drugs in prisons, or the creation of risk. As noted by EMCDDA, ‘One possible outcome…is that there may be displacement from use of synthetic cannabinoids to other substances, such as synthetic opioids, which may also be extremely harmful.’ Indeed, the EMCDDA notes that the use of synthetic opioids in Latvian prisons ‘has been accompanied by more overdoses and an increase in injecting, including needle-sharing’.

The UK Prison Inspectorate has stated that ‘NPS have created significant additional harm and are now the most serious threat to the safety and security of the prison system’. The widespread use of NPS, driven in part by random drug testing, suggests that the MDT is having the opposite effect of that intended by the government. In 2005, MDT was withdrawn from Scottish prisons as it was deemed a waste of funds that had little effective impact on drug use amongst prisoners.

Such negative ‘unintended consequences’ can also be identified from other supply reduction efforts. Drug detecting sniffer dogs are widely used throughout the UK prison regime. A 2014 review of supply reduction activities in Australian prisons described the impact of sniffer dogs as ‘modest’. However, even this ‘modest’ success is undermined in the case of new psychoactives. The EMCDDA, for example, cautions that, ‘Sniffer dogs are not trained to recognise the many different types of NPS.’ The UK Prison Inspectorate has noted that ‘Synthetic cannabis has no distinctive odour and is therefore harder to detect than non-synthetic cannabis, making it more attractive to smuggle in’. Even where dogs are trained specifically to identify one type of NPS, such as ‘Spice’, the longer-term effectiveness of this is made difficult by ‘the ever-changing composition’ of new psychoactives, making the programmes ‘ineffectual’.

Drug use is as much a part of the prison environment as it is the outside community. Overall, the supply reduction activities of prison regimes fuel drug-related risk and drug-related harms among people in detention. The advent of NPS only exacerbates this, creating an environment in which use of new psychoactive substances, substances often more dangerous than the traditional drugs they are created to mimic, are the easiest to smuggle in, and the most logical to use if wishing to avoid detection.

If governments are truly serious about addressing drug use and reducing drug-related harm, they must move away from enforcement-focussed responses, and instead implement laws and policies that reduce the number of people in prison for drug-related offences, and to provide comprehensive harm reduction programmes for people in detention.

*Dr Rick Lines is Associate Professor of Criminology and Human Rights at the School of Law, Swansea University. He is also a Senior Research Associate with the Global Drug Policy Observatory. Olivia Howells is a Law and Criminology student at Swansea University and Daniel Webb is a Criminology and Criminal Justice student at Swansea University.

This research was conducted as part of the Swansea Paid Internship Network programme, a scheme enabling School of Law students to obtain experience working on an active research project under the guidance of an academic supervisor.

Nowhere to hide: It’s high time we measured countries’ performance in drug policy

By Marie Nougier IDPC Head of Research and Communications & Dave Bewley-Taylor, GDPO Director

First published here by IPDC, October 2019

Traditionally, the UN and governments have measured progress in drug policy in terms of flows and scale; principally the numbers of people arrested, hectares of drug crops eradicated and the amounts of drugs seized. For years now, IDPC and many civil society colleagues (in particular the Global Drug Policy Observatory (GDPO), CELS, the Centre on Drug Policy Evaluation, and the Social Science Research Council among others), have advocated against such an approach, because of its inability to truly assess the real impacts of drug control policy – especially for communities affected by the illicit drug trade on the one hand and by drug policies on the other.

The 2016 UN General Assembly Special Session (UNGASS) was instrumental in pushing the boundaries of UN drug policy to consider issues related to health, human rights, social inclusion, criminal justice reform and how all of this might contribute to the 2030 Agenda for Sustainable Development. However, while recent years have seen a welcome increase in focus on the adverse health consequences of drug use and interventions aiming to reduce them, the United Nations Office on Drugs and Crime (UNODC) and many member states have thus far been resistant to incorporate these critical elements into their main data collection tool – the Annual Reports Questionnaire (ARQ). The ongoing review of this tool has so far been a missed opportunity to fully reconsider what success in global drug policy should look like.

In 2018, IDPC published our landmark Shadow Report ‘Taking stock: A decade of drug policy’, in which we assessed the progress made – or rather, the lack thereof – in global drug policy since the adoption of the 2009 Political Declaration and Plan of Action on drugs, to inform the Ministerial Segment of March 2019. Collaborative work by the IDPC network and other civil society experts was instrumental to obtaining a full picture of the global situation relating drug control approaches on demand and supply, but also on the impacts of drug policies on the broader UN priorities of promoting human rights, development, and advancing peace and security. What we found was extremely worrying. While the UN was in many ways side-stepping difficult questions, drug policies in many parts of the world had become responsible for increased HIV and hepatitis C infections among people who inject drugs, half a million drug use-related deaths in 2015 alone, and tens of thousands of people falling victim to extrajudicial killings, as well as arbitrary and compulsory detention. In the meantime, the prevalence of drug use, the hectares of crops cultivated for the illicit drug trade, and the tons of drugs trafficked had reached record highs. But far from being a wake-up call, UN drug policy debates in Vienna have mainly continued to rely on the business-as-usual approach.

Faced with the clear lack of appetite from both governments and the UN to evaluate the impacts of drug control on communities worldwide in any meaningful way, it seems likely that civil society will once again need to take a proactive stance. The critical role played by civil society in holding governments accountable by creating transparent and informative policy evaluation tools is not a new idea. This has been done before in various policy areas. For instance, Transparency International has, for some time now, been tracking progress made by countries across the world in reducing corruption, with the Global Corruption Perception Index. Journalists without Borders has done the same with their World Press Freedom Index. And the list continues. Indeed, it is now widely recognised that the ‘soft power’ of indices is capable of exerting considerable social pressure and can – via a number of interrelated process – be a potent lever for the generation of policy change.

With this in mind, IDPC and GDPO have now embarked on a similar endeavour, faced with the urgent need to develop a tool that would enable us to track drug policy developments worldwide in a systematic and scientific way, as well as to assess how effective these turned out to be on the ground. The results of this analysis would enable us to compare policies adopted between various countries, and track evolution over time, as well as rank countries according to how well their drug policies have been able to foster improved health, human rights protection, gender equality, social inclusion or violence reduction.

Learning from other composite indices, the proposed Global Drug Policy Index (GDPI) would be a collaborative civil society endeavour (as was the case for the Shadow Report), with the aim of increasing transparency in decision making processes around drugs, promoting new indicators to evaluate drug control, facilitating the participation of civil society in data collection, and ultimately supporting more humane policies and reforms.

We are still in the preliminary stages of development and fundraising for this ambitious tool, but we are excited by the advocacy opportunities that a carefully designed Global Drug Policy Index will bring to the global and national debates on drug policy for the years to come. Stay tuned for more information!

What have the Russians done for us in the international drug policy field? A timely reminder to take back control

Axel Klein, GDPO Senior Research Associate.
April 24, 2019.

At the 62nd meeting of the UN Commission on Narcotic Drugs (CND) in March this year the tensions between states with widely diverging drug policies finally came to the surface. On the floor of the plenary meeting the Russian delegation took Canada to task for ‘violating international law [by] legalising cannabis.’ (http://cndblog.org/2019/03/plenary-item-9-implementation-of-the-international-drug-control-treaties-cont-2/)

The Russia delegate also took issue with the Expert Commission on Drug Dependence of the World Health Organisation for recommending that cannabis be moved from schedule 4 of the 1961 Single Convention on Narcotic Drugs and placed in the less strict schedule 1. Interestingly, the objection had nothing to do with either the new assessment of the harms posed by cannabis or its medical potential. What had given cause to offence was that the ‘perception of the world of the community would be that legalisation is fine and dandy. Probably the experts don’t have to go through the turmoil of thinking through the repercussions of their decisions. They are technical experts. Nothing more’ (emphasis added).

Technical issues, say of patient benefit, the need to address discrimination and stigma, or pre-empt trafficking were not touched upon. The Russian Federation’s statement also glossed over the fact that the placement was not designed to be permanently fixed. The original founders of the system expected that substances would move across the schedules as more scientific evidence became available. Important to recall here is that at the time that cannabis was slotted into schedule 4, tetrahydrocannabinol, the most important psychoactive substance, had not even been discovered.

The point of Russia’s attack on countries like Canada, Uruguay and several US states– though only Canada was singled out – was the risks that legalisation was having consequences.

Consequentialism has not been a driving force in the history of international drug control, given the ontological foundation of the treaties on the ‘welfare of mankind’. The system architects recruited ‘mankind’ to labour in the construction and then retire. Hence the object of Russian concern were not people in their totality or diverse sub-populations – patients, drug consumers, communities – but the ‘international drug control system’ itself.

Taking this to its logical conclusion, we then understand that adhering to the provisions of the three drug control conventions and the various associated agreements and protocols is only indirectly to do with problems of addiction and substance misuse. Their overriding purpose lies in protecting the functionaries and officials who work in it.

Such proposals tend to resonate particularly with representatives of countries with natural resource-based economies and authoritarian regimes. If the recent focus on human rights has already opened a divide between countries, the question of accountability is likely to push them even further apart. Justifying costly layers of administration to tax-paying electorates (though not to universities), is difficult at the best of times, but particularly when they fail to have a positive purpose.

And yet this is what the international system has long been lacking, at least according to Antonio Maria Costa, the former head of UNODC. In a seminal address to the CND in 2008 he stated with counter-intuitive perspicacity, that the ‘system was no longer fit for purpose’ and unable to contain a number of displacements.(Costa, Antonia Maria, Making drug control ‘fit for purpose’ Building on the UNGASS decade, Report by the Executive Director of the UNODC, 2008) The first he mentioned was the ‘huge criminal black market that now thrives in order to get prohibited substances from producers to consumers.’ Along with these markets comes the full spectrum of crime from large, police and policy corrupting syndicates to addiction fueled shoplifting. Such crime is the trade-off for containing the public health that is threatened by open drug markets. It is on this Faustian pact that the system is build.

(Antonia Maria Costa, UNODC)

Picking up on the admonition by the Russian delegate to consider the repercussions of our actions we need to review the criminogenic effect of drug control. This has to be done repeatedly and publicly precisely because it runs counter to the popular assumptions. In popular folklore, police and paramilitaries are believed to be breaking down doors and shooting up laboratories in ‘response’ to drug criminals. In effect, the causal effect runs the other way. The harder police and magistrates squeeze drug supply, the more devious and brutal the industry becomes when meeting the demand.

The fact that drug control generates crime needs to be repeated to policy makers at every level and may even hold sway with an audience that is otherwise immune to arguments about human rights, patient needs or stigmatization.

At the CND in Vienna most national delegations are comprised of and led by senior law enforcement officers or officials of the Ministry of Interior. If the realisation that vigorous enforcement is resulting in ever more vigorous criminality has not so far had much effect comes down to one of two possible sets of explanation. First, it could be that they are (i) simply not listening, (ii) the causal chain has not been understood, or (iii) is simply not believed. But the second explanation is that the criminal justice sector agencies and public have different objectives. The former are interested in expanding and increasing means and powers to enforce the law. And if public safety is one of the outcomes, so much the better.

In accordance with key tenets of institutional economics we hold that drug control and law enforcement are driven by motives of any social organism – self perpetuation. Hence the need for continuous checks and assessments of policy purpose and outcomes. Since all institutions also include well intentioned and dedicated professionals the need for restating the arguments of criminogenic consequence has to be repeated over and over.

Naturally it is much more difficult to achieve results in thematic areas where key policy decisions have been abstracted by remote and unaccountable international bodies. As the Russian delegate reminds of the importance of repercussions, it is high time to take back control.

The Psychoactive Consumer and International Drug Policy: A Sweeping Sketch

The Psychoactive Consumer and International Drug Policy: A Sweeping Sketch

Christopher Hallam, PhD
GDPO Research Associate

The role of the consumer, in its complexity and diversity, is often marginalised in analyses of drug policy. Of course, it is obvious that consumers play a part – if nobody were smoking, injecting, drinking or otherwise consuming psychoactive materials, there would not be a control regime trying to stop them. However, the consumers of drugs are a variegated group; their tastes for multiple psychoactive substances are formed by complex, often hybrid, cultures, and are satisfied by globalised industries and services. The forces of governance and the regimes of control are confronted not by a monolithic consumer and supplier, but by multifaceted appetites that are poorly understood by those seeking to suppress them. They are stimulated by the very attempt at control.
If we examine the historical foundations of the international control apparatus, its ground zero lies in China and its intricate population of opium smokers – or rather, the ways in which that population was constructed by the imperial powers, which possessed the economic, social and technological authority to enforce their will. The United States of America should be included in this grouping, as it had recently taken colonial possession of the Philippines following its brief war with Spain; it is notable that the beginnings of the US’s imperial period coincided with the inception of its global drugs project. Indeed, the occupation of the Philippines was tightly bound up with the suppression of opium smoking amongst the Chinese inhabitants of the islands.

Chinese opium smokers, lodging house, San Francisco (late C19th)

The Chinese diaspora, travelling to many parts of the world in search of work, carried the practice of opium smoking with it. Settling into Chinatowns across the planet, the diaspora became the object of indigenous fear and loathing, often centred on concerns over economics and the sexual possession of women. The cultural practice of opium smoking became a symbolic locus of this ontological panic (which underlay the ‘moral panic’), while governments constructed legislation to suppress the smoking of opium, before moving on to other drugs.

Opium smoking found its way from the Chinese diaspora into sub-groups within the indigenous population. Sex workers, the sporting classes, the underworld, the bohemias of modern cities, these took up the practice of opium smoking, followed by other drugs and modes of consumption: such use was a badge of otherness, a sign that one shared with the immigrant the status of outsider: the mark of the elective alien. The movement of psychoactive drug cultures from modernity’s ethnic diasporas into the indigenous population was an object of anxiety for nation states preoccupied with identity and borders. It was a movement that began with the Chinese but followed on successive waves of people of colour. The spread of bohemian culture – the ideas and attitudes of the elective alien – would, as the twentieth century developed, bring drugs into the youth movements of the 1950s and after.
The drug culture and the project of drug control are, therefore, profoundly bound up with conflicting patterns of identity and belief in modern societies. They are thoroughly symbolic and tied in complex ways to the process of modernity itself.
The responses of governments and international organisations to these developments are too many and varied to cover in their specificity here. However, a few general trends can be traced. The attempt to suppress the consumption of one drug led to the development of new, stronger and more mobile replacements – a trend which remains apparent today in the proliferation of hundreds of new psychoactive substances. In a final irony, the assembled discursive authority of governments, legislators, law enforcement agencies, educational systems, and finally bodies concerned specifically with ‘prevention’ have, in their vocal pronouncements against the evils of drug consumption, succeeded only in stimulating the appetite, and identifying it with freedom.
It is high time for a new approach.
Current policies are linked to an impoverished understanding of drug consumption, based upon assumptions current within the cultures of contemporary states. One could summarise these understandings as centred on ‘theories of absence’- in short, the idea people only take drugs because they’ve got something missing in their lives, either genetically or psychologically (for the political right) or in terms of social capital (for the left). Policies therefore are either repressive or therapeutic. None of them have been very effective so far.
On the other hand, if drug consumption is, as I have argued above, intimately bound up with the history and cultures of modernity, and is fundamentally part of the processes of modernity, there’s no point in these approaches. Instead, policies must integrate drugs and their users into a more generous cultural mainstream. The only approach that fits into the reality of the situation is a form of harm reduction, which accepts drug consumption and sets out to ameliorate the risks and harmful impacts of it. But the conception of harm reduction I’m suggesting here would be an extremely broad one, which includes acceptance of the benefits of some modes of drug use.

Chris Hallam, PhD

February 2019

Better to Ask Forgiveness than Permission: Spain’s Sub-National Approach to Drug Policy

Better to Ask Forgiveness Than Permission: What the rest of the world can learn from Spain’s approaches to drug policy

The movement for drug policy reform is a global one – and it has become increasingly important to look at what other countries are doing on drug policy to see what can be learned. Portugal’s decriminalization model and Switzerland’s pioneering role in heroin-assisted treatment have been studied extensively, and there’s an emerging field of promising research evaluating state-level cannabis legalization in the U.S.

Overlooked in this discussion is Spain, where certain sub-national entities (similar to states in the U.S.) have implemented innovative approaches to drug policy based on the principles of harm reduction and a rejection of prohibitionist principles.

A new report, released today, takes a deep dive into Spain’s drug policy reform. What makes these reforms interesting is that they’ve succeeded in spite of the central government, not because of it – an approach that we call “better to ask forgiveness than ask permission”.

The best-known of Spain’s drug policy innovations are cannabis social clubs, which emerged in Catalonia and the Basque Country and have now spread throughout the country. These clubs utilize ambiguities in the law to allow the use and distribution of cannabis to their members under certain circumstances.

And Spain isn’t just noteworthy for its cannabis policies. The U.S. and other countries can learn a lot from Spain’s successful harm reduction interventions, which include safe consumption spaces, heroin-assisted treatment, take-home methadone, opioid substitution and syringe programs in prison, mobile methadone clinics, and drug checking services to prevent accidental overdoses.

At the same time, Spain has never technically criminalized drug possession, meaning that drugs are essentially decriminalized. Nonetheless, there are many fines and fees for possessing drugs, making Spain’s policy more punitive than Portugal’s.

While Portugal’s model is often seen as a beacon for reformers, political realities make its implementation in places like the U.S. very challenging. Portugal’s national drug decriminalization policy was comprehensively implemented in 2001 by its central government. It’s unlikely that the U.S. federal government – especially the current one – would implement drug decriminalization nationally without states moving forward on the issue first.

Spain’s political system – autonomous regions and a central government – largely mirrors that of the U.S, with states having a level of autonomy on many issues despite there being a strong role for the federal government. As we have seen with cannabis reform in the U.S., states will take action on certain drug policy issues even when the federal government expressly opposes it. Spain provides a potential roadmap for how U.S. states can implement cutting-edge drug policies in other areas, beyond cannabis.

Since many of Spain’s reforms are undertaken by autonomous regions, there is still a risk that the central government could try to undo their progress. This report was concluded a few days before Spain’s President Rajoy was dismissed by parliament and the new socialist government of Pedro Sanchez came to power. Changes in public policy are expected on many fronts, including drug policy and other public health issues.

However, until now, the Socialist Party has yet to embrace drug policy reforms.

This report serves as a guide for countries around the world, as well as the new Spanish government, to understand how and why Spain’s drug policy reforms have succeeded so far – and where improvement is needed in the coming years.

You can read the full report here: Full Report

Constanza Sánchez is a GDPO Research Associate and the Law, Policy and Human Rights Director at ICEERS

Michael Collins is the Deputy Director at Drug Policy Alliance’s Office of National Affairs. He just spent 9 months in Catalonia, working on drug policy.

**The Spanish version of this policy briefing will be available soon / La version en español de este informe estará disponible muy pronto.

GDPO collaboration with Central European University on MPA student project

As part of its mission to provide dug policy research and publication opportunities for postgraduates and early career scholars, over the course of the past year the Global Drug Policy Observatory has been pleased to have worked with three second year students studying on the Master of Public Administration (MPA) course at the School of Public Policy, Central European University (CEU), Budapest. Under the supervision of Julia Buxton, Professor of Comparative Politics within the School and Observatory Senior Research Associate, and with oversight from Dave Bewley-Taylor, Jasmin Gamez, Anna Maria Džunić and Mai Hla Aye of the Applied Policy Project worked to develop the GDPO’s publication streams in a number of key areas. As well as researching and writing Situation Analyses (SAs) of their own – on the environmental impact of the regulated cannabis market in California, gender and drug policy, and synthetic drugs in Hungary – the students successfully commissioned and assisted with the editing of series of SAs and a Policy Brief from academics and practitioners working in the drug field from among other places India, Pakistan, Ghana, South Africa and East Africa region. These publications cover a wide range of relevant policy issues including current policy reforms in Ghana, South Africa, and the East African region, developments within crypto-drug markets, access to essential medicine, drug policy and depictions of drugs users in gaming and access to harm reduction in prisons. The students are also currently working on the production of videos on decriminalization, synthetic drugs and drug policy metrics. The Observatory will be publishing and posting the outcomes of the Project over the next few months, beginning with a SA on Crypto-market Enforcement – New Strategy and Tactics by Alois Afilipoaie and Patrick Shortis that can be found here. The GDPO team would like to thank the commissioned authors as well as Jasmin, Anna, and Mai for all their hard work. We wish them all the best for the future.

L-R – Mai, Jasmin, and Anna

Measuring Drug Policy Outcomes: Intersections with Human Rights and the Sustainable Development Goals (SDGs)

The following blog was first posted by Nazlee Maghsoudi, ICSDP, 07/05/2018
Original link; http://www.icsdp.org/measuring_drug_policy_outcomes_intersections_with_human_rights_and_the_sustainable_development_goals_sdgs

For the sixth consecutive year, a side event was held at the 61st Session of the Commission on Narcotic Drugs (CND) to continue the global discussion on reprioritizing the objectives and indicators used to evaluate drug policies.

Pic 1Recent years have seen a growing appreciation for the intersections between drug policy and the sustainable development agenda, particularly in relation to human rights. Against this backdrop, and as preparations for the High-Level Ministerial Segment of the CND in 2019 continue, the Government of Switzerland, Office of the High Commissioner for Human Rights (OHCHR), International Drug Policy Consortium (IDPC), Centro De Estudios Legales Y Sociales, Social Science Research Council (SSRC), Global Drug Policy Observatory, and the ICSDP held a side event to examine how the sustainable development agenda might offer opportunities for more effectively measuring the impact of drugs and drug policies, including on human rights.

With the event expertly moderated by Mr. Adrian Franco, National Institute of Statistics and Geography, Mexico, Ms. Cleia Noia, Programme Manager for the Drugs, Security and Democracy Programme at SSRC, began the session by sharing recommendations from a new publication by the International Expert Group on Drug Policy Metrics. Titled, “Aligning Agendas: Drugs, Sustainable Development, and the Drive for Policy Coherence,” the discussion paper argues that aligning the way we measure and evaluate drug policies with the 2030 sustainable development agenda would have two clear benefits; first, such harmonization would help to overcome many of the limitations of drug policies resulting from suboptimal metrics for measuring their impact, and second, help to ensure drug policies enhance, rather than hinder, efforts to achieve the SDGs. Ms. Noia stressed that drug policies must be designed in coordination with other relevant policy agendas to guarantee that achievements in one are not undermined by those in another. A recognition of the interconnectedness of policy agendas is reflected in SDG 17, specifically target 17.14 to “enhance policy coherence for sustainable development.” A key recommendation from the International Expert Group on Drug Policy Metrics is therefore for the UN Deputy Secretary-General to establish a process for developing adequate indicators for target 17.14, including a framework for coherence between drug policy and sustainable development. System-wide coherence would be further reinforced by another recommendation shared by Ms. Noia, which called for the UN Statistical Commission to consider the addition of further SDG indicators related to drugs and drug policies. While only SDG 3 on health and wellbeing includes an explicit indicator in this area, there are at least four other SDGs, as outlined in the discussion paper, that are well positioned for the addition of indicators related to drugs and drug policies. Noting that the window of opportunity is rapidly closing, Ms. Noia concluded by asking Member States to consider how the procedures in place for the sustainable development agenda could be expanded to include their interactions with drug policies, in order to avoid embedding blind spots that would undermine achievement of the SDGs.

Offering concrete examples of drug policy indicators that could be incorporated into the SDG framework, Ms. Marie Nougier, Head of Research and Communications at IDPC, focused on the interactions between drug policy and SDG 5 on gender equality. Pic_2_croppedBeginning with target 5.1 for the end of all forms of discrimination against women, Ms. Nougier stressed that this could be supported through the addition of an indicator measuring cases of discrimination faced by women who use drugs accessing health and social services, given the heightened stigma experienced by this key population. For target 5.2 on the elimination of violence against women, including trafficking and sexual and other types of exploitation, Ms. Nougier emphasized that the SDG indicators framework must track the number of women coerced into the illegal drug market, but also cases of violence by law enforcement officials against women who use drugs, as well as measuring rates of impunity for such cases.

Pic_2_cropped

Beyond SDG 5, many other goals and targets could be used to address the issues affecting women and drugs, including Target 1.4 on equal rights to economic resources, or Target 3.3 on ending AIDS by 2030. These represent just a few examples of the many indicators that could be incorporated into the SDG indicator framework, as well as into other international and national evaluation mechanisms on drug policy impacts, such as the Annual Report Questionnaire (ARQ) – the principal mechanism through which Member States report on the impacts of their drug policies to the UN. Ms. Nougier cautioned that without deliberate efforts to apply a gender perspective to the evaluation of drug policies, this will remain a blind spot and certainly hinder the achievement of SDG 5. This will also require that key aspects of the UNGASS Outcome Document be incorporated into the ARQ to ensure that more opportunities are offered for Member States to report back on gender-disaggregated data.

Christian Schneider, Drug Markets and Drug Policy Analyst at the Swiss Federal Office of Police, built upon the discussion by noting that even if indicators are in place, the limitations of the mechanisms used to gather data must also be taken into account. As a contributor to the ARQ, Mr. Schneider has seen firsthand the limitations and challenges posed by self-reported data. Mr. Schneider suggested that the sustainable development agenda and the UNGASS Outcome Document provide an impetus to address gaps in drug policy evaluation by supplementing self-reported ARQs with data sources from other actors, such as civil society organizations. The UNGASS Outcome Document presents several opportunities for improving the evaluation of drug policies, including paragraph 4(h), which suggestspic3_cropped.png the inclusion of human rights information in Member States’ reporting on the implementation of the three drug control conventions, and paragraph 7(g) on improving impact assessments by employing relevant human development indicators and other measurements in line with the SDGs. Mr. Zaved Mahmood, Human Rights Officer at the OHCHR, further emphasized that these can serve as entry points for human rights data collection. Mr. Mahmood shared a recent publication from the OHCHR, titled, “Human Rights Indicators: A Guide to Measurement and Implementation,” which contains relevant guidance for the incorporation of human rights indicators into the evaluations of drug policies. As the review process for the consideration of improvements to the quality and effectiveness of the ARQ continues, Mr. Mahmood encouraged Member States to use this opportunity to consider a more holistic approach to the evaluation of drug policies and ensure the inclusion of indicators pertaining to human rights.

Referring to CND Resolution 60/1 (paragraph 6), Mr. Mahmood also urged Member States to explore possibilities to strengthen existing data collection and analysis tools at the national level by using human rights indicators.

Click here to visit the CND Blog’s live reporting from this side event.

Written by: Nazlee Maghsoudi, Knowledge Translation Manager at the ICSDP

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

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

Khalid Tinasti
Honorary Research Associate, Swansea University
July 2017

Introduction:

The Maghreb countries – Algeria, Libya, Mauritania, Morocco and Tunisia – while seldom discussed, are crucial to global debates on drug control policies. These countries are at the heart of drug trafficking routes for various substances, from Latin America to Europe, from the Middle East to Europe, and from West Africa to North America. The region is also home to the largest producers of cannabis, as well as amphetamine type stimulants (ATS). Illicit drugs are prohibited and drug laws are harsh if not efficient – Mauritania retains death penalty for drug-related offences.

The Maghreb (in green), copyright epidop.com

This blog will focus on two of these countries, Tunisia and Mauritania, who share common religious, ethnic groups, cultural and socio-economic realities, but face clearly different challenges related to illicit drugs.[i] The two countries nevertheless face a drug trafficking framework which is unparalleled. In fact, the Maghreb and its neighbouring Sahel region represent large desert areas, sparsely populated, with porous borders and the existence of terrorist and other separatist groups. These parameters, combined with failed states and inadequate drug control policies, make drug trafficking thrive. This blog attempts – through available data and literature – to analyse the drug situation currently in both countries, review their drug control laws, and evaluate the outcomes of their implementation. The piece also narrates the current efforts to reform the drug law by the Tunisian government.

The current situation:

There are an estimated 140,000 people who use drugs (PWUD) in Tunisia,[1] with around 10,000 people injecting drugs.[2] Other sources report up to 400.000 PWUD in the country.[3] In 2015, 21.44% of new HIV infections were among people who inject drugs.[4] Moreover, HIV prevalence among this same population has increased from 3% in 2011 to 4% in 2014, while it is of 0,1% in the general population.[5] This increase takes place in the absence of a national strategy of harm reduction. There are no opioid substitution programmes, and the distribution of syringes is mainly undertaken by non-governmental organizations. In 2013, the 48.000 syringes distributed in the country were by the ATIOST, the ATUPRET and the ATL-MST.[6] The prevalence of hepatitis C in the same population is 29%.[ii]

Drug control policies are steered through law 52 adopted in February 1992 – referred to as law 92-52. The law, which sentences prison terms even for simple use or consumption, has resulted in an unprecedented prison overcrowding, mainly targeting young males incarcerated on cannabis use charges. Out of the 25.000 inmates in the country prisons, 8.000 are incarcerated for drug offences, of which it is estimated that 9 out of 10 are there for simple possession or personal use,1 the law allowing for urine tests in prisons and in the community to prove the consumption. In 2015, 7.451 people were arrested and prosecuted for drug offences, of which about 70% were related to cannabis possession or consumption.[7] A year later, 8.984 people were arrested on the same charges, with 6.212 of them aged 18 to 30 years old.[8]

In Mauritania, data on the prevalence of drug use is unavailable. Similarly, the prevalence of HIV among the general population reaching 0,6%, the prevalence among people who inject or use drugs is unavailable. More worryingly, the National Committee to fight AIDS does not recognize PWID as a key population most at risk of acquiring HIV.[9], The non-inclusion of PWUD as a key population deters a discussion on evidence-based interventions to respond to AIDS, including prevention, harm reduction services and treatment.

Rather, the debate on drugs focuses heavily on trafficking, with Mauritanian authorities, media and other stakeholders considering that the country is only a transit country. This vision of a country where illicit drugs transit – through the routes of Senegal, Mali, Algeria, Niger, Morocco or the Canary Islands – and where there is no local consumption is emphasized by the geographic position of Mauritania, its limited population (4 million inhabitants), and a large, desert and difficult to control territory. Whether such assertion is true or not – it remains difficult to define in the lack of data on illicit drug use – the country rightly faces challenges related to the smuggling and trafficking of drugs, intertwined with terrorist groups’ financing and their unlawful intrusion in the Mauritanian territory. Drug-related cases often make the headlines in Mauritanian media, due to the large seizures of illicit drugs by customs and law enforcement agents, including cases where relatives of former Presidents or former Presidents themselves are cited.[10][11] The nature of the implication of political authorities in drug trafficking remains anecdotal since it is not proven. Nevertheless, the characteristics of drug trafficking depends on many parameters that are specific to Mauritania and the Sahel region. As stated earlier, the country has a large desert territory that is difficult to control. Moreover, trafficking relies on ethnic groups, their inter-relationships and their control of their territories that transcend the Sahel borders.[12]

Drug seizure in northern Mauritania by the Gendarmerie (military law enforcement). Copyright Sahara Medias

Very limited data shows that there is a small cannabis production in the south of the country near the Senegal River, while cocaine is imported from Latin America and heroin from Asia through Nigeria or other West African countries.[13] Trafficking of illicit drugs includes alcohol, which is a banned substance in Mauritania. Moreover, Mauritania’s authorities address money laundering as the banking system is sensitive to drug profits laundering, mainly due to the important volume of foreign currency circulating from tradespeople and other economic emigrants working mainly in the Gulf countries.

The laws and policies for drug use and trafficking:

Tunisia, country of the Jasmine revolution and youth-driven democratization, has the harshest law in terms of repression of drug use and possession for personal use. Mauritania, on the other hand, is the only Maghreb country sentencing drug traffickers and growers/producers to death penalty.

The Tunisian law – to be explored in more detail below – punishes individuals who consume or possess a narcotic or psychotropic drug with imprisonment of one to five years and with a monetary fine between 400 and 1.200 USD (1.000 to 3.000 Tunisian Dinars). It also punishes the attempt to consume or possess drugs with the same sanction. Therefore, the Tunisian law punishes the possession for the purpose of consumption and for the actual consumption even if there is no possession involved. The court may as well force the convicted offender to undergo detoxification for a period set by a medical doctor at a public hospital. If the detoxification is refused, a permit can be issued by the president of the court forcing the offender to undergo this treatment in a compulsory manner.[14] The most problematic provision of the law, until its partial reform in April 2017 (see following section), was article 12 of the law, providing that judges cannot take into account mitigating factors, and have to pronounce a prison sentence for drug use offences. This was problematic as the law 52 was the only one in the Tunisian criminal code to deprive judges of their free choice and of sentencing proportionally to the offences. Under the terms of the law as well, traffickers and growers of narcotics are sentenced to prison terms from 6 to 10 years, while those importing or exporting drugs face a minimum of ten years of incarceration, up to a life sentence.

“Our kids and friends are not criminals #end law 52”[iii]

In Mauritania, the law responds to drug use and possession for personal use by a prison term of a maximum of two years and a monetary fine between 140 and 280 USD (50.000 to 100.000 Mauritanian Ouguiya). Prosecutors also have the obligation to inform health authorities about the arrest of people who use drugs. The health authorities investigate the health conditions and family conditions of the arrested individual, and prescribe mandatory detoxification. Producers and growers of illicit drugs face 15 to 30 years in prison, the same penalty as drug traffickers. This punishment, in case of recidivists, becomes a sentence to the capital punishment. Finally, laundering illicit drugs’ profits is punished by a prison term between 10 to 40 years.[15]

It is also important to note that both laws have been amended and adopted following the adoption of the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances in 1988 and right before the adoption of the Arab Convention against Illicit Use of and Traffic in Narcotic Drugs and Psychotropic Substances in 1994. The articles of both countries’ laws and the lack of proportionality vis-à-vis the real severity of the offences represent an example of the interpretation countries make of the international drug conventions, and the impact these conventions have on people’s lives when implemented on the ground, far from the debates of diplomats drafting and negotiating them in multilateral forums.

What reform for the Tunisian drug law?

In Tunisia, the excessive number of young people arrested under the provisions of law 92-52 started a heated debate on the need for its reform. This debate has been deepened through the use of the law provisions to arrest young Jasmine revolutionaries, and by their own capacity to stand for their rights in the post-Revolution era.[16] Movements such as the Sajin52 (prisoner 52) emerged and denounced the law. In his 2014 presidential campaign, the current head of state Béji Caïd Essebsi promised a reform of the law and denounced the use of prison terms for first-time drug use. In December 2015, his government approved a new narcotics bill to amend law 52, and introduce the following provisions: i) the establishment of a national drug observatory to collect data; ii) the establishment of treatment centres, including the introduction of substitution therapy; iii) the diversion of first and second-time offenders, arrested for use, to social services (third-time offenders will serve the same terms as the current law provides, between one and five years); and iv) the possibility of judges to decide on the most appropriate sentences.[17]

Infographic by the movement “Al habes lé” (no incarceration) calling to reform law 52

The latter, targeted at article 12 of law 92-52, has been amended in April 2017 when Parliament gave judges the right to apply Article 53 of the Criminal Code to reduce penalties, not only for consumption, detention and consumer intent (Article 4 of law 52) but also for attending consumption spaces (Article 8 of Law 52).[18]

The process leading to this partial amendment started with the submission to Parliament of bill 79 amending law 52. With the bill not finding a majority necessary for passage into law for more than 12 months, President Essebsi decided in January 2017 to use his executive powers to freeze all the arrests related to Law 92-52, and urged Parliament to find a consensus and vote for the reform. A month later, the President convened a meeting of the National Security Council, which decided to revise the criteria for granting special grace to people charged with drug use or possession, and to have the Grace Committee meet once a month to overturn the judges’ decisions on arrests. The National Security Council also repealed partially law 92-52, and specifically its article 12 leading to the reform of April 2017 by Parliament, giving judges the capacity to take into account mitigating factors.

In the current economic, social and security framework in Tunisia, where tensions among society are numerous – from the declining standards of living of the population, the decline of the industrial, tourism and service sectors, as well as the security and fight against terrorism – the calendar of the adoption of bill 79 in Parliament remains unclear.

Conclusion:

The debate on drug policies in the Maghreb, when it occurs, is usually focused on Morocco, the largest producer of cannabis in the world, and one of the main suppliers of the European Union due to its geographic proximity with Spain. With the deterioration of the security situation in the Sahel and the rise of terrorist risks, along with some evidence that terrorist groups are either involved in trafficking, protect traffickers or benefit from trafficking revenues,[19] combined with the disintegration of the state apparatus in the fifth Maghreb country, Libya, is also beginning to attract some interest.

Nevertheless, as discussed here, other states within the region are increasingly worthy of attention with debate around drug policy emerging for a complex range of internal, societal and social peace reasons.
Tunisia is currently being driven to reform its policies due to the population’s pressure, while this debate does not exist in Mauritania. However, while differences exist on this point,, the two countries seem to share a common lack of understanding of drug policies, providing similar legal responses to people who use drugs (PWUD), to small players in the illegal drug market (small dealers, farmers and other couriers), and to large-scale traffickers and terrorist groups suspected of trafficking illicit drugs to fund their terror actions. Such policies, intended to deter drugs’ presence in society, are failing to achieve their objectives and are extremely costly to society, to the criminal justice and health systems.

While it remains unclear when the Tunisian drug policy reform will take place, it provides the brightest prospect of reform in the Maghreb, as bill 79 will bring along the first policies based on evidence, and provide space for scientific monitoring to inform and fill gaps in the future. The adoption of this bill, its successful implementation and flexibility, as well as its tight monitoring is all highly important not only for the Tunisian society but the whole Maghreb.

[I] This is the second and last blog on drug policy in the Maghreb. The first blog was published in October 2016 and titled “View from the Ground – Harm reduction, drug policy and the law in the Maghreb: focus on Morocco and Algeria”.

[ii] In Mauritania, HIV key populations are female sex workers and their clients, women and youth, inmates, people living with STIs, truckers, sailors and fishermen.

[iii]Protest against law 52 in front of the Assembly of the Representatives of the People (Parliament) on 28 December 2015. Copyright Nawaat

[1] Amraoui, A. Drogues : une jeunesse victime de l’échec de la politique de prévention. Nawaat.org; September 2015. Available from: https://nawaat.org/portail/2015/09/05/tunisie-drogues-jeunesse-victime-echec-politique-prevention/ (accessed 10 July 2017)

[2] Tunisie Numérique. 10 000 toxicomanes usagers de drogue intraveineuse en Tunisie. Turess; April 2012. Available from: http://www.turess.com/fr/numerique/119208 (accessed 10 July 2017)

[3] Bentamansourt, N. Tunisie-Drogue : 3,9% des consommateurs contaminés par le VIH! African Manager; October 2016. Available from: https://africanmanager.com/mots-cles/association-tunisienne-de-la-prevention-contre-la-toxicomanie/ (accessed 10 July 2017)

[4] Africaine Santé. VIH/SIDA en Tunisie: Où en est-on? December 2015. Available from: http://africaine-sante.com.tn/a-la-une/vihsida-en-tunisie-ou-en-est-on/ (accessed 10 July 2017)

[5] UNAIDS. Key Populations Atlas: Tunisia- People who inject drugs: HIV Prevalence 2014. UNAIDS; 2014. Available from: http://www.aidsinfoonline.org/kpatlas/#/home (accessed 10 July 2017)

[6] National HIV/AIDS Programme of Tunisia. Rapport d’activités sur la riposte au sida 2012-2013. UNAIDS; 2014.

[7] Human Rights Watch. « Tout ça pour un joint » La loi répressive sur la drogue en Tunisie et comment la réformer. Tunis; December 2015. Available from: https://www.hrw.org/sites/default/files/report_pdf/tunisia0216fr_sumandrecs_.pdf (accessed 11 July 2017)

[8] African Manager. Tunisie-stupéfiants : Le bilan de 2016 en chiffres. March 2017. Available from: https://africanmanager.com/tunisie-stupefiants-le-bilan-de-2016-en-chiffres/ (accessed 10 July 2017)

[9] Comité national de lutte contre le Sida. Rapport d’activité sur la réponse au sida en Mauritanie 2014. Nouakchott; March 2014. Available from: http://www.unaids.org/sites/default/files/country/documents/MRT_narrative_report_2014.pdf (accessed 10 July 2017)

[10] Berghezan, G. Panorama du trafic de cocaïne en Afrique de l’Ouest. Group for Research and Information on Peace and Security: Brussels; June 2012.

[11] Attar, A. Mauritanie : fin de parcours pour Mohamed Ould Abdel Aziz ?. Afrik.com; February 2013. Available from: http://www.afrik.com/mauritanie-fin-de-parcours-pour-mohamed-ould-abdel-aziz (accessed 10 July 2017)

[12] Simon, J. « Le Sahel comme espace de transit des stupéfiants. Acteurs et conséquences politiques ». Hérodote, 142 (3); 2011: pp. 125-142.

[13] Dialogues, propositions, histoires. « La situation des drogues en Mauritanie ». DPH: Paris; citing the Observatoire géopolitique des drogues; November 1994. Available from: http://base.d-p-h.info/fr/fiches/premierdph/fiche-premierdph-2016.html (accessed 11 July 2017)

[14] Official Journal of the Tunisian Republic No. 33 of 1992. Law No. 92-52 of 18 May 1992 on Narcotic drugs. Tunis; 1992.

[15] République Islamique de Mauritanie. Loi No. 93-37 relative à la répression de la production, du trafic et de l’usage illicite des stupéfiants et substances Psychotropes. Nouakchott ; July 1993.

[16] Tinasti, K. Are cannabis laws used for political repression in the Arab Spring countries?. Addiction, 110 (12); 2015: p. 2037.

[17] Tunisian government. Projet de loi N 79 de l’année 2015 relatif aux stupéfiants. Tunis; 2015.

[18] Huffpost Tunisie. Tunisie-La loi 52 a été amendée: “Une étape considérable franchie” se félicite l’avocat Ghazi Mrabet. Huffpostmaghreb.com; April 2017. Available from: http://www.huffpostmaghreb.com/2017/04/25/tunisie-loi-52-stupefiant_n_16231606.html (accessed 12 July 2017)

[19] UNODC. World Drug Report 2017, booklet 5. Vienna; June 2017

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.