Category Archives: international drug policy

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

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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.

Copyright West Africa Commission on Drugs, 2014

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

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British System, American Century: A short case study

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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.

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Trust in the Crypto-Drug Markets

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By Juan Fernandez Ochoa
Team Assistant – IDPC

Despite perceived novelty, drugs have been online from the Internet’s very beginnings.  Anecdotal as it may be, it is widely understood that the very first transaction on ARPANET involved a small amount of cannabis. Ever since, cyberspace has provided fertile ground for all sorts of drug-related exchanges.

The appeal of the Internet for people who use drugs is evident. Faced with criminalisation, misinformation and stigma “offline”, the world-wide web can offer people who use drugs a space to interact in [relative] anonymity and safety. Online forums, such as Erowid, have provided a platform for people to share experiences and advice related to their drug use; fostering a sense of community that remains difficult to replicate “in real life”.

Silk Road, however, was a game changer. Launched in February 2011, the site was the first “archetypical” crypto-drug marketi. This “eBay for drugs” combined sophisticated encryption, communications and trust technologies to offer a broad range of [mostly illicit] products and services to users around the world. Cannabis, LSD, MDMA and other controlled substances were now just a click away… plus shipping & handling.

As it is often the case with drug-related developments in a context of prohibition, the initial response from public authorities ranged from cluelessness, to politically expedient outrage, to repression. Less than three years into the Silk Road experiment, and before the site’s impact on the market could be fully understood, the FBI shut it down. Its convicted mastermind, Ross Ulbricht, now serves a life sentence without parole in a federal prison in New York.

Mirroring the reality of “physical” markets, dismantling the Silk Road, and subsequent similar operations, have achieved anything but the intended effects. The original site might no longer exist, but dozens more have been created in its stead, with overall sales and reach continuing to grow at a gradual but unwavering pace.

Despite the available evidence, the role of public authorities in this evolving ecosystem continues to go unchecked. The UNGASS Outcome Document urges Member States to “strengthen law enforcement, criminal justice and legal responses, as well as international cooperation, to prevent and counter drug-related criminal activities using the Internet” (Art. 5 p). As if expecting different results from doing the same thing over and over again.

In stark contrast with a mainstream law enforcement discourse that perceives these online markets essentially as “a safe haven for criminals”, the burgeoning field of research on crypto-drug markets reveals a more nuanced landscape. An interdisciplinary research project on trust in these markets by the Global Drug Policy Observatory (GDPO)ii, for instance, can shed light on the short-sightedness of fundamentally repressive law enforcement interventions targeting crypto-drug markets.

Borrowing tools from linguistics, ethnography and computer science, the investigators have sifted through thousands of megabytes of messages from the now-defunct Silk Road[s] 1 and 2iii. The careful analysis of “collocates”iv has made it possible to produce a statistically meaningful snapshot of some of the prevailing discourses in these communications.

One strand of the project, led by Professor Nuria Lorenzo-Dus, revealed that trust among users was largely mediated by the exchange of personal experiences and other forms of knowledge, as well as the provision of advice on how to reduce potential harmful effects of drug use. User-based harm reduction strategies have been previously identified in crypto-drug markets and offline communitiesv. However, by focusing on the issue of trust, the authors centre and highlight the social bonds underpinning this “indigenous harm reduction”. Public authorities should consider the opportuneness of law enforcement responses that might entail weakening these community strategiesvi, favouring interventions that support the life and health of people who use drugs insteadvii.

A second project strand, headed by Martin Horton-Eddison, provides further evidence on the unintended, although not unexpected, consequences of “hard” law enforcement interventions. Using the same methodology and sources, the study suggests the takedown of Silk Road by the FBI acted as a starting gun for technological innovation in crypto-drug markets – resulting in even more difficulties for law enforcement to target the dark net. Specifically, this research captures the emergence of collective concerns about the “escrow” system.

Escrow has been an essential trait of crypto-drug markets, mitigating some of the multiple risks associated to online transactions. A number of these risks are related to the non-abidance by one of the parties to the terms of the sale/purchase. In the absence of formal institutions to act as arbiters, crypto-drug markets stepped in to fill the gap, offering a service that holds the funds until the other parties (in this case the buyer and seller) both agree to release them. When Silk Road 1 was seized, the FBI expropriated $3.6million from the system. Immediately after Silk Road 2 came to exist, users began to discuss ways to offset these potential losses. Intensified by major “exit scams”, these anxieties in the community seem to have led to the development of better alternatives, such as decentralised and multi-signature escrow systems. Law enforcement action, in short, made crypto-drug markets more resilient and possibly sustainable.

The insights from these studies strongly mirror certain realities of offline drug markets. The global drug control regime has a conspicuous track record of futile interventions that are not motivated, and in fact come at the expense of the wellbeing of people who use drugs. Crypto-drug markets, which are often framed as a threat in international policy debates, might actually offer an opportunity to provide remedial action. Public authorities should rethink their engagement with these spaces, capitalising on the self-regulatory and harm reduction practices deployed by these communities to positively influence, support and empower people who use drugs on- and offline.

This blog post draws on material presented at the Roundtable on Cyber-Trust in Crypto-Drug Markets: Implications for Policy and Policing (London, 21 February 2017), organised by the International Institute for Strategic Studies (IISS) and the Global Drug Policy Observatory (GDPO), with support from the International Drug Policy Consortium (IDPC) and the Challenging Human Environments and Research Impact for a Sustainable and Healthy Digital Economy (CHERISH-DE) fund.

Notes

i Crypto-drug markets can be defined as “digital platforms that facilitate P2P trade of goods and services with the added features of recommendations systems and a reliance on cryptocurrencies such as bitcoin. They utilize anonymizing Internet-routing technologies [….] to conceal the physical-[world] identity and location of users and create and open network for such interactions”.

ii Swansea University.

iii February 2011 – October 2013 and Nov. 2013 – November 2014, respectively.

iv Words that co-occur with statistical significance, denoting “features of the data that are both salient and peculiar”. Di Cristofaro, M. & Horton-Eddison, M. (2017) Corpus Linguistics on the Silk Road(s): The Escrow Example, GDPO Situation Analysis.

v See, for instance: Bancroft, A., & Reid, P. S. (2016). Concepts of illicit drug quality among darknet market users: Purity, embodied experience, craft and chemical knowledge. International Journal of Drug Policy, 35, 42–49; and Friedman, S. R., de Jong, W., Rossi, D., Touzé, G., Rockwell, R., Des Jarlais, D. C., & Elovich, R. (2007). Harm reduction theory: Users’ culture, micro-social indigenous harm reduction, and the self-organization and outside organizing of users’ groups. International Journal of Drug Policy, 18(2), 107–117.

vi For more on law enforcement and harm reduction, see, for instance: Monaghan, G., Bewley-Taylor, D., 2013. Modernising Drug Law Enforcement – Report 1 Police Support for Harm Reduction Policies and Practices Towards People Who Inject Drugs. International Drug Policy Consortium, London

vii See, for instance: Caudevilla, F. The Emergence of Deep Web Marketplaces: A Health Perspective. The Internet and Drugs Market (European Monitoring Center for Drugs and Drug Addiction). Publications Office of the European Union, Luxembourg; 2016.

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Preparing for 2019: Drug Policy Objectives and Indicators, System-wide Coherence and the Sustainable Development Agenda

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Preparing for 2019: Drug Policy Objectives and Indicators, System-wide Coherence and the Sustainable Development Agenda

Side event held at the 60th Commission on Narcotic Drugs offers insights into how drug policy indicators could aid in achieving the sustainable development agenda.

Nazlee Maghsoudi, Knowledge Translation Manager at the ICSDP

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

With the UNGASS on the World Drug Problem now a year behind us, member states are looking towards the next international drug policy milestone, a High Level Ministerial Meeting in 2019. Simultaneously, member states are over a year into efforts to achieve the Sustainable Development Goals (SDGs), a set of global targets to end poverty, protect the planet, and ensure prosperity by 2030. Given increasing recognition that the impacts of global drug policy are intrinsically linked to a number of SDGs, the Government of Switzerland, Health Poverty Action (HPA), International Drug Policy Consortium, Centro De Estudios Legales Y Sociales (CELS), Social Science Research Council, Global Drug Policy Observatory (GDPO), and the International Centre for Science in Drug Policy (ICSDP) came together at the 60th Session of the Commission on Narcotic Drugs (CND) to explore how drug policy indicators could aid member states in more effectively achieving the sustainable development agenda.

Natasha Horsfield, Policy & Advocacy Officer from HPA, outlined crucial ways in which drugs and drug policy interact with several of the SDGs, and suggested that metrics for measuring how drug policies are contributing to the SDGs should be prioritized in preparations for 2019. Speaking about goal 1 on poverty, goal 2 on food security, and goal 5 on gender equality, Ms. Horsfield explained that marginalization and inequality are important elements in the drug trade, with poverty and food insecurity a frequent factor in involvement in illicit drug markets, and women particularly becoming involved as drug couriers because of their gendered social and economic vulnerabilities. Gender inequality is reflected in the disproportionate and alarming increase in the incarceration of women for minor drugs offences. Given these and other intersections between drug policy and the SDGs, the clear, measurable, and internationally agreed framework of targets and indicators contained within the sustainable development agenda could be adapted to measure drug policy outcomes. For example, new indicators could be adopted at national level under goal 5 to measure women and girls involved in the drug trade or incarcerated for drug crimes. Ms. Horsfield also stressed that the High Level Ministerial Meeting in 2019 presents an opportune moment to align the timeline for the next drug policy framework with the 2030 deadline for implementing the SDGs.

Elaborating on Ms. Horsfield’s remarks, Luciana Pol, Senior Fellow in Security Policy & Human Rights from CELS, pointed to improvements that could be made to drug policy indicators to support the achievement of SDG 5 on gender equality. Ms. Pol noted that the Special Rapporteur on violence against women has identified anti-drug policies specifically as a leading cause of the rising rates of incarceration of women globally, and data demonstrates that a portion of women incarcerated for drug offences are coerced into trafficking and others engage as a result of lacking viable economic opportunities. Ms. Pol described concrete ways to improve the quality of data on how drug policies impact women. First, prison data should have a gender perspective by including, for example, information on the amount of pregnant women, of children incarcerated with their mothers, and access to health services for these groups. Second, since laws in many countries don’t distinguish between different types of drug offences, small and large scale trafficking are categorized together. Differentiating between the conduct for which they are incarcerated and the roles women play will improve our understanding of incarcerated populations. Ms. Pol reminded the audience that improving our understanding of how drug policies impact women is not only essential to ensuring the achievement of SDG 5, but is also a central component of last year’s CND resolution 59/5. Ms. Pol therefore called on member states to take these and other concrete steps to mainstream a gender perspective in their collection of data relevant to drugs and drug policy, and urged UN agencies to guide member states in this process of broadening and expanding their drug policy metrics.
As a contributor on law enforcement indicators to the World Drug Report, Christian Schneider, Strategic Analyst at the Federal Office of Police in Bern, Switzerland, shared his firsthand knowledge that the incomplete nature of data on drug markets can prohibit efforts to derive meaningful policy recommendations. In addition to communicating uncertainties, Mr. Schneider proposed that gaps in the data could be addressed by adopting a more comprehensive set of indicators. Sharing technical recommendations for implementing Mr. Schneider’s suggestion, Dave Bewley-Taylor, Director of GDPO, focused on how a review of the Annual Report Questionnaires (ARQs) could support the achievement of the SDGs by aligning drug policy metrics with the sustainable development agenda. According to Prof. Bewley-Taylor, despite the limitations of self-reporting, the ARQs are a useful mechanism through which member states report on their efforts to address the world drug problem. As the nature of the world drug problem has evolved, however, there have been increasing gaps in the data collected by the ARQs. This recently came into sharp focus, as the UNGASS Outcome Document included an operational recommendation to use relevant human development indicators in alignment with the SDGs to increase understanding and improve impact assessments. Within this context, Prof. Bewley-Taylor stressed that there is a clear need to review the structure and questions of the ARQs to bring them into alignment with the SDGs by incorporating indicators related to human rights, public health, and human security. Such a review could be conducted through an interagency expert group established by the Statistical Commission, which has already begun considering these issues.

Discussions on drug policy indicators and their relationship to the sustainable development agenda are undoubtedly of utmost importance at the CND, and in other forums, such as the meeting of the high-level political forum on sustainable development in July 2017. Yet, much more than discussion is needed. As Ms. Horsfield said, advancing past this critical juncture will require political will from member states beyond simply reaffirming their commitment to SDGs, but towards deemphasizing drug control efforts that undermine the SDGs and funding those that contribute positively to their achievement. Aligning drug policy metrics with the SDGs is an important step in this direction.

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

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Why is coca production on the rise in Colombia?

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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

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

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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.

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

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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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View from the Ground: Infrastructure and Coca in Guaviare, Colombia

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By Alastair Smith, GDPO Research Associate.

In mid-May 2015, Ross, Dave and I left the relatively comfortable climate of Bogotá and headed to the humidity of South East Colombia and the Department of Guaviare to conduct fieldwork. Leaving the Department’s capital, San José del Guaviare, Pedro Arenas – the city’s previous mayor, current director of the Observatory of Declared Illicit Crops and Cultivators at the NGO INDEPAZ, and our guide for the weekend – explained that although Guaviare has been settled since time of Spanish conquistadors, the rural population greatly increased during and after the period of Colombian history known as ‘The Violence’. This was a ten year period (1948-58) of civil war in Colombia when the Colombian Conservative Party and the Colombian Liberal Party fought for dominance, and during which it is estimated that some 200,000 lives were lost. In an effort to flee the problems that came to San José, much of its population moved further into the countryside both temporarily and permanently. Pedro further explained that after the upheaval, the government offered land titles and investment to those moving to the rural area. However, as the government failed to honour these promises, an increasing population was left with little other than subsistence farming for their survival (Ortiz, 1984). As a capitalist economy grew around them, campesinos became aware of the opportunities to sell the traditional crop of coca for conversion into cocaine. For the first time, the communities were faced with the opportunity to stabilise their subsistence existence and offer a decent future to their families – although they lived nothing like the extravagant lifestyles synonymous with processors and traffickers working higher in the supply chain.

Moving through the countryside, the panoramic pasture with its sparse population of cattle – apparently underused for productivity, as powerful interests accumulate land primarily as an investment and a status symbol – began to merge into patches, and then significant areas of uncleared jungle. As we sat in the rear of our 4×4, cushioning ourselves against the contours of the dirt track road (only reasonably passable with such a vehicle or motorbike, and the expert manipulation of Freddy our driver), our travel companion, a local community leader, explained the basic truths of coca production. His language was human, straightforward and non-technical; yet he eloquently outlined a situation which formal national and international drugs policy in Latin America and Colombia, has always, and continues to largely disregard.

The community has been born into a context where the possibilities of development constantly fail to emerge due to a lack of even the most basic of investment. While there are major roads that connect San José to Bogotá and other large regional centres, the majority of communities remain connected only by dirt tracks, which are in a volatile state due to the local climate. Our own travel time consumed four hours in both directions, despite moving only 60km into the interior. As explained by other community leaders, the lack of reliable and passable roads drastically impede the sale of legal agricultural produce to local urban markets: long travel times undermine the ability to provide a reliable supply and drastically increase the transport costs associated with the purchase of inputs and sale of the final products.

In the country as a whole, 75% of roads are paved and generally in good condition (Ministerio de Transporte, 2014). However, those in the countryside are the least developed and least well maintained. A quick comparison, undertaken back at our hotel, identified something of a correlation between the UN 2013 estimates of coca growing and government statistics on the existence and quality of roads. To take one example, in Putumayo, the second biggest producer of coca, only 54% of roads are paved, and over 57% of the remaining dirt track routes are currently evaluated to be in “bad” or “very bad” condition (Ministerio de Transporte, 2014)

In the morning we were lucky enough to have met with the Governor of the Department of Guaviare, José Octaviano Rivera Moncada. Moving from a campesino family into politics, inspired he said by the lack of representation that he witnessed as he travelled the region as a rural health worker, the Governor explained that his department was critically underfunded, pointing out that while his administration had been able to make investments, it was almost entirely the result of locally raised funds. The central Government does not provide sufficient support for development in his view. One reason for this, as suggested by a number of people we met during our time in Guaviare, is that there is little incentive for politicians and government officials to provide for the isolated communities. By way of explanation, people point out that the political support in the region is of little consequence, and there is better status (and some say money) to be generated (through corruption and kickbacks) by focusing efforts elsewhere.

By generous invitation we accompanied the Governor to a village where we had the opportunity to participate in a momentous event in the community’s history. In the year 2015, this village was to be connected to the electricity grid: meaning that until that day, the households there had been among the 6,300 in the department, and 435,500 nationwide, officially estimated to be living without an electricity supply of any kind (MMEUPME, 2014). Again, reviewing numbers of households without electricity in the departments where coca is grown reveals a potentially telling pattern. Indeed, talking at the event, we met with further leaders from surrounding villages also still without this basis economic input. Talking of their current economic situation, they posed the rhetorical question: ‘How are we to generate income for our communities without electricity?’ ‘How are we expected to store food crops in a way which keeps them suitable for market?’ The answer they immediately follow with is the logically obvious one: ‘We simply can’t’. It is perhaps partly for this reason that coca tends to be grown in areas with notable levels of poverty (see Table 1, below – although, it should be noted that statistical analysis correlates coca with mid-levels of poverty, likely because of the need for some capacity to engage in the activity). Overall, we encountered the same position in all the communities we visited: the people are desperate for alternative livelihood options, but without roads and electricity, from which one leader noted many other opportunities would come, the only rational option for those seeking to provide for their families is to grow coca leaf. After all, in contrast to others, this crop grows easily in the region, and can be transported by the buyers on motorbikes.

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Back in San José, we talked with a corn dealer, who elaborated on the impact of what we had seen and heard in the countryside. Although the man had dedicated himself to trading corn – partly in order to help small farmers in the region, Pedro suggested – the ageing trader is only able to pay a price to farmers that is barely, if at all, sufficient to cover their costs of production. While this ratio is impacted by competition from industrial producers and growing imports under Colombia’s free trade agreements, there is little chance that market incentives drive efficiency in Guaviare given the constraints imposed by a lack of basic rural infrastructure. Here, I am reminded of my work in the field of international development, and the need to compliment policies to develop market incentives (the primary focus of the trade agreements and market liberlisation pushed by international institutions, such as the World Trade Organization and the International Monetary Fund), with investment in building the economic capacity that people need to respond (Smith 2009).

Finally then, on the issue of investment in development, the other topic at the centre of many conversations on our trip to Guaviare, was the Colombian Government’s policy – heavily backed by the United States – to reduce the production of coca through aerial fumigation. Recent news reaching the communities supported previous analyses demonstrating that the fumigation programme, estimated to have cost between US$1 billion and US$2 billion since its launch in 1994 (Isacson, 2015), has done little to reduce cultivation (ONDCP, 2015); aside from the heinous damage inflicted on human health and the environment, as recently identified by the WHO (2015). In this situation, campesinos, well aware of the financial cost of each fumigation flight, ask a very logical question: Why does the government not direct investment into roads and electricity, instead of dropping chemicals that along with killing coca, destroy legal food crops, cause cancer and damage our natural resources? Indeed, undertaking statistical analysis of the characteristics associated with growing coca, nationwide studies find that while fumigation is little associated with reducing coca cultivation (with a minor and statistically insignificant association) there is a strong statistically significant correlation between the size of the coca crop and transport infrastructure (for example see: Dion and Russler, 2008). On the basis of the evidence then, a clear conclusion emerges: if the Colombian and US Governments are serious about reducing coca cultivation, it is essential to invest more seriously in the kind of economic development needed to support legal livelihood opportunities for the rural populations of Colombia. Indeed, if the balance between investment in fumigation and development does not change, it is high time the international community asked more critical questions about the continuation of such an ineffective and inhuman drugs policy in areas such Guaviare.

Table 1: Basic infrastructure for largest coca producing regions in Colombia (DANE 2014; MMEUPME 2014; Ministerio de Transporte 2014).

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References

DANE (Departamento Administrativo Nacional de Estadística) 2014. Cifras Departamentales De Pobreza Monetaria Y Desigualdad. https://www.dane.gov.co/files/investigaciones/condiciones_vida/pobreza/cp_pobreza_departamentos_R2013.pdf.

Dion, M.L., Russler, C., 2008. Eradication Efforts, the State, Displacement and Poverty: Explaining Coca Cultivation in Colombia During Plan Colombia. Journal of Latin American Studies 40 (03), 399-421.

Isacson, A. 2015. Even If Glyphosate Were Safe, Fumigation in Colombia Would Be a Bad Policy. Here’s Why. Washington: Washington Office on Latin America. http://www.wola.org/commentary/even_if_glyphosate_were_safe_fumigation_in_colombia_would_be_a_bad_policy_heres_why.

Ministerio de Transporte 2014. Transporte En Cifras 2013. https://www.mintransporte.gov.co/descargar.php?idFile=11527.

MMEUPME (Ministerio de Minas y Energía Unidad de Planeación Minero Energética) 2014. Plan Indicativo De Expansión De Cobertura De Energía Eléctrica 2013 – 2017. http://www.upme.gov.co/Siel/Siel/Portals/0/Piec/Libro_PIEC.pdf.

ONDCP (Office of National Drug Control Policy) 2015. Coca in the Andes. https://www.whitehouse.gov/ondcp/targeting-cocaine-at-the-source.

Ortiz, S. 1984. Colonization in the Colombian Amazon. Frontier expansion in Amazonia, pp. 204-230.

UNODC (United Nations Office on Drugs and Crime) 2014. Colombia Coca Cultivation Survey 2013. http://www.unodc.org/documents/crop-monitoring/Colombia/Colombia_coca_cultivation_survey_2013.pdf.

Smith, A.M., 2009. Fair Trade, Diversification and Structural Change: Towards a Broader Theoretical Framework of Analysis. Oxford Development Studies 37 (4), 457-478

WHO (World Health Organisation) 2015. Iarc Monographs Volume 112: Evaluation of Five Organophosphate Insecticides and Herbicides. http://www.iarc.fr/en/media-centre/iarcnews/pdf/MonographVolume112.pdf.

WHO (World Health Organisation) 2015. Iarc Monographs Volume 112: Evaluation of Five Organophosphate Insecticides and Herbicides. http://www.iarc.fr/en/media-centre/iarcnews/pdf/MonographVolume112.pdf.

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Ketamine under international law

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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.

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The ketamine controversy, continued

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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.

A 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

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