Side event – The world drug perception problem

Organized by the Governments of Portugal, Switzerland and Uruguay, and the Global Commission on Drug Policy.

Pavel Bém,Commissioner, Global Commission on Drug Policy: The Global Commission on Drug Policy aims to bring to the international level science-based discussions. Humane ways and interventions to reduce the harmful consequences of the use of drugs, and of enforced drug policies at the regional and national levels. The Commission has produced 7 reports. We consider crucial to ensure access to essential and controlled medicines, to end the criminalisation of people who use drugs, to channel efforts into non-punitive approaches to drug policy and to experiment with the legal regulation of currently controlled substances. The latest report concerns prejudice and stigma.

Michel Katazchkine, Global Commission on Drug Policy: Our latest report is on how prejudice feeds into prohibitionist policies. How these fears and misconceptions are an obstacle to the design and implementation of drug policy reform. It has been endorsed by all Commissioners, as it is for all reports. It contrasts fears with facts. A few examples: 1) Almost all drugs automatically lead to “addition”. UNODC estimates that 11.6% of users face problematic drug use. The most common pattern of drug use s episodic and not problematic; not dependence. 2) It’s a widespread belief that automatic addiction follows contact with drugs. Actually, 9% people who use cannabis develop problematic use. It’s higher for alcohol and tobacco. 3) Drugs are perceived as unnatural contaminants that come from the outside. In reality, psychoactive substances have always been with us in human history. And there are very few individuals who do not consume any psychoactive substances (alcohol, tobacco, chocolate, khat, or anything else). 4) People come to think that currently-illicit drugs are among the most dangerous; however, the work by David Nutt shows there’s little relation between scheduling and actual harm levels. 5) The danger of drugs is often also related to the adulterants present in them. 6) In many societies, people who use drugs would be weak, or irresponsible, or immoral. Transgressors. The research and evidence that we have shows that there are many reasons for people to use drugs (experimentation, pleasure, etc.). Several studies show that there isn’t a particular difference between levels of education/employment between people who use drugs and the average. The report has led us to consider prejudice and its impacts as a vicious circle, feeding negative policies that heighten stigma, marginalisation and risks. So we need to change the way we speak about drugs and people who use drugs. And policy-makers should provide better information and adapt policies so that they’re not stigmatising. The medical community needs to be vocal in taking the lead in fighting stigma and discrimination in health-related settings. Ahead of the Ministerial Segment of 2019, we invite you to review the use of language in international documents and negociations.

Nora Kronig Romero, Ambassador for Global Health, Switzerland: We have very little evidence on the perception of people who use drugs in the 1990s in Switzerland. In open-drug scenes, the police was pushing people who use drugs to stop. Constant pressure, they thought, would solve the problem. There wasn’t really a public debate on the issue. Most people, if they weren’t concerned directly, thought it wasn’t their problem. Two popular initiatives: 1) Pushing for a repressive national drug policy aiming for a drug-free society in the country; 2) One pushing for legalisation. The Swiss population voted against them. It reaffirmed the State’s four-pillar approach, with people at the centre. What changed? It gave us the opportunity to push the public opinion to make the law be approved in the middle of the year 2000. What led to the approval of this new law? 1) A failure of the way to solve the drug problem only with law enforcement actions (with echoes in the international press shedding light on open-air drug scenes). 2) We had tried pilots of alternative approaches. Some cities took the lead and showed it was possible to have harm reduction projects that contributed to solve the problem. 3) As we vote very often, we provide plenty of information often; there’s a public debate ongoing on a regular basis. The failure of these two rejected positions pushed us to think through other options. We’re criticised because of our direct democracy, but looking at what we have achieved, I think we have progressed substantially. But also individual citizens taking matters into their hands (ex. nurses that went to see people who used drugs in open-air scenes and provided health interventions for thousands). Always go back to evidence, putting the facts in the centre.

Martín Rodríguez, Institute for the Regulation and Control of Cannabis (IRCCA), Uruguay: In December 2013, the Parliament enacted the legal regulation of cannabis. Based on a human rights focus and to reduce the incidence of drug trafficking and drug-related crime. The IRCCA was created. The possession of personal use was decriminalised since 1974. Users continued to be stigmatised and discriminated. Now that the market is completely regulated, we’re still not beyond discrimination. The new legal framework was not a result of a popular vote. The implementation began with non-medical access (domestic growers and cannabis membership clubs). Perceptions can change relatively qucikly. Before starting the sale, in 2016, the opinion polls show that 3/4 people were against. After 6 months, rejection fell by half. Several concerns have failed to materialised. Being a cannabis user, doesn’t mean you’re a criminal, or being incapable of working. 50% of the people registered to buy cannabis, is older than 30 years. There are adjustments to make, but we’re already dispelling myths: no episodes of violence between users or around sale places, not a single robbery in pharmacies, the number of people registered grew more than 400% in the first month, personal information is strictly protected, the production and distribution chain ensures great traceability, product complies with strict quality standards, strong communications campaign explaining the risks and the reasons to regulate.

João Goulão, National Drug Coordinator, Portugal: In Portugal, when we decided to decriminalise, we reached very high levels of problematic drug use, even if prevalence was relatively low. Explosion of experimentation after democratisation in all social groups. This was a crucial reason why there was widespread support for change. The Ministry of Justice was also on board. Very sensitive people participated of the process. The current Secretary General, became Prime Minister, and launched the challenge to do something differently. The rest of the world was doing the “war on drugs”. Guterres invited a group of experts to think about a different strategy. I was honoured to be a part of it. The only limit was the Treaties. We proposed a strategy approved by the government in 1999. We proposed the decriminalisation of every drug, because the issue was criminalisation, not each substance. It change just one article of our drugs law. If you have a dose of over 10 days, you are dealt with without the criminal system. The threshold is important. (…)

Judy Chang, International Network of People who Use Drugs (INPUD): Ending the vicious cycle implies challenging the language used against our communities. We are treated as scapegoats for societal problems. We need to challenge extrajudicial killings, mass incarceration, language that stigmatises and dehumanises. Only in recent times and because of a certain political environment our lives are used for political gains. Quick summary about the war on drugs and its link to racism. Anti-drug laws have been used against Chinese migrants and other ethnic minorities in the US and beyond. Continuation of incendiary rhetoric to discriminate. Earlier movements for equality focused on language, it is one domain through which identities are expressed. We reject otherising language, terms that are dehumanising, the use of terminology that complies with the disease model. We can lead happy fulfilling lives.

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