International Drug Policy Consortium: What work has the UNODC done (in particular in collaboration with the WHO) to highlight the need for ‘overdose prevention’ and the provision of harm reduction interventions as a central element of countries’ response to the current overdose crisis?
Yury Fedotov, UNODC: We collaborate on a number of issues, including on overdose prevention. We have worked with WHO for a number of years. Two years ago, we launched the SOS initiative. It includes in particular emergency methadone. We would like to expand further, like all our activities regarding prevention. Unfortunately, we have limited funds. The study protocol is available to use and should help us raise more funds in overdose prevention. If you need additional information, my colleague from the Health branch could discuss with you.
Dalgarno Institute: We would strongly endorse conversations around, not only evidence-based mechanisms for increasing/enhancing/empowering Demand Reduction, but to engage the issue from a more anthropological (rather than mere sociological) approach, as a priority. There is an urgent need to not only identify but call out as ‘counter-productive/sabotaging’, illicit drug use promoting missives in the policy/practice space; particularly that use ‘Harm Reduction’ as a cover for the promotion/permission modes. We need to ensure that best practice for delaying and denying uptake is priority and that Harm Reduction is about drug use exiting strategies, not drug use normalisation tactics. Important matrixes for review must include following questions. Does this policy interpretation endorse, empower, enable or equip ongoing drug use? Or Does the policy interpretation reduce, remediate or facilitate drug use exiting recovery, from illicit drug use? Is this an approach UNODC endorses?
Yury Fedotov, UNODC: The CND, as the drug policymaking body of the UN drug control system has endorsed the full range of interventions, including primary prevention, measures to reduce the health and social consequences of use, treatment, rehabilitation and reintegration. I understand the concern of the question, especially why it’s important community based treatment and UNODC does not support nonmedical uses of controlled substances.
Drustvo AREAL: Does UNODC run any programs specifically geared towards migrants and/or refugees with drug use disorders? Do they include Opiod Substitution Therapies (OST)? If not, why?
Yury Fedotov, UNODC: It’s a very pertinent and good question. Unfortunately, at the moment we do not have a complete and comprehensive programme on the matter. Because of a lack of funds. Our interventions are done on a case by case basis. In particular, rapid assessment in Uganda, for instance, which led to the establishment of a family based prevention programme with refugees, to encourage the protective capacity of parents and resilience in difficult circumstances. On HIV prevention, programme refugees in neighbouring country, Afghanistan. But, of course, it’s very important to extend such support to vulnerable people, migrants, refugees and displaced personas. We are trying to raise additional funds to be more supportive.
Paroles Autour de la Santé: The countries we work in suffer from a tramadol crisis – does UNODC recommend strategies to counter such crises especially in light of a widespread lack of OST and insufficient access to treatment in general?
Yury Fedotov, UNODC: I appreciate the challenges in this area and the UNODC has launched an integrated strategy jointly with WHO to support countries in addressing tramadol and the boarder issue of nonmedical use of opioid. On Monday, our office launched a toolkit as part of our strategy. IT brings together practical innovative resources form the UN family to support targeted effective responses on prevention, treatment, access to medicines, regulation, interdiction, etc. It’s very serious. There’s no magic bullet. Continued coordinated solution
Asociación Proyecto Hombre: From our experience of more than 20 years implementing evidence-based prevention programmes across Spain, we have realized of the necessity to include evidence-based prevention plans in the regional and national drug policies as a cornerstone to diminish the world drug problem. Again, the 2018 World Drug Report affirmed that prevention interventions have to begin at an early age and be adapted to the stage of development and the needs of children, adolescents, youth and their communities.
How Member States are taking adequate measures to provide effective prevention reaching as much families as possible and focusing on the most vulnerable groups such as children or women.
Yury Fedotov, UNODC: We support 30 countries in piloting family-based programmes and have been able to document positive impact on the resilience and development of children as a result. Unfortunately, the programmes are not so comprehensive and the number of countries is limited. Which is why we’re developing campaigns and agree we need to start at an early age. We launched an important programme, ListenFisrst, we look forward to continent to develop. We’re focused on supporting poor countries to develop family based activities. Specifically tailored to low and very low resource sittings including displaced populations. These programmes are in the public domain. After this part of our meeting, my colleagues in the Prevention and Health branch could discuss further details.
Smart Approaches to Marijuana: What is your position on State Parties legalizing cannabis around the country (USA)?
Is this allowed under UN conventions and do you think this is a good or bad development?
Yury Fedotov, UNODC: Cannabis is regulated by the UN conventions on drug control. Whatever is not supported by the conventions, by definition contravenes international law. In the case of the US, the federal level is committed to the implementation oft the UN conventions. At the same time, legislation adopted in some states of the United States. That’s an issue between the federal government and the states. IT’s reflected in our world drug report to see what the impact would be of legalisation. And how it could affect the implementation of the Conventions. As far as a more general questions about legalisation of some drugs. The INCB is an independent treaty mandated to monitor the implementation of the Convention’s and recently. With regards to the decision of a national government, the Board expressed it contravenes the Treaties. I’d advice my position is very clear. One country cannot change the provision of the international law. The modification of Conventions is a matter for states to decide.
Slum Child Foundation: Where I work that is in the informal settlements we have young men and women who make illicit alcohol to support and sustain their families, these are just a fraction of those doing this work, what alternate development plans, interventions or programs are you putting in place to ensure that once these young people leave what they are doing they can have to support themselves, as CSO’s we tell them to stop doing what they are doing but we lack an alternate plan that is evidence-based.
Yury Fedotov, UNODC: Firstly, I appreciate the work you are doing. It’s an example of civil society supporting people. The experience is based on what they’re doing in the field in the most difficult environment. The problem is very serious. If we look at UNODC standards on supporting families and sending children to school…we need to have schools, and capacity, basic funding. Building schools, providing nutrition, etc. is an important issue. I’m afraid even if we discuss alternative development, which is very important, we need to understand that we cannot solve this issue on the basis of dealing with the drugs issue. It requires concentrated and consolidated agencies to address development, including in the framework of the implementation of the SDGs. I hope that the reforms of the Secretary General, aimed at bringing agencies closer together, will help all of us address this issue more comprehensively and efficiently. We will work with partners to ensure we build capacity and respond relevantly.
Foundation for Alternative Approaches to Addiction Think & Do Tank (FAAAT): A little over 110 years ago, the International Opium Commission was established in the first ever attempt to ban trade on narcotic drugs. In 1998 the UN General Assembly committed its Member States to achieve a “drug free world” by “eliminating or significantly reducing” production of opium, cocaine and cannabis. Since the 1998 goals were set in place the number of deaths related to cartel violence, in Mexico alone, reached their highest peak in 2017 at 29,178, which is the highest annual homicide rate, since comparable recordkeeping began in 1997. Add to that figure the US opioid drug overdose death rate, during 2017, reported by the CDC at more than 70, 200 persons and we have reached almost 100,000 dead in just two countries of North America in one year. How can the policies be modified to create a more balanced approach to the health risks of drug abuse without creating a prohibitionist environment under which traffickers can thrive and drug users are imprisoned as criminals?
Yury Fedotov, UNODC: All basic documents, including the latest Ministerial Declaration, support the balanced approach to the drug challenges in the world. UNODC works closely with Member States to support their efforts. A balanced approach means an approach that addresses the core of the issue in a way, as initially provided by the Conventions, to protect the health and welfare of mankind. We need to do it in new circumstances, despite great challenges, focusing on people’s health and rights, their capacity to recover from drug dependency. A balanced approach means a balanced approach. The other side, law enforcement, is important. It’s not the main purpose, but without supply reduction, it’s very hard to make sure there’s a clear reduction in demand and the number of deaths as a result of drug use in the world. Almost half a million every year. So we need to support the implementation of documents in a balanced way. But also the response to criminality.
International Center for Ethnobotanical Education Research amd Service (ICEERS): Taking into consideration that indigenous peoples, especially women, have been historically vulnerable to drug control policies. Does UNODC have any intention or strategy for including them into their decision-making processes, when decisions affecting their lives are being made?
Yury Fedotov, UNODC: It’s not only about UNODC but the UN family at large. UN supports MS to implement relevant international conventions, standards and norms and focuses on provisions that exclude and prohibit discrimination. This includes drug control policies. IN our work, we support gender mainstreaming and the empowerment of women to ensure representation of women. We established a special unit in my office to support gender mainstreaming in our programmatic and country work. The Bangkok Rules and Nelson Mandela Rules are also relevant here. IT’s important to continue providing access to justice for vulnerable and marginalised populations including indigenous people. That may include restorative justice, some approaches inspired by older traditions. There are many ways to address this issue and I encourage you to continue doing what you’re doing and we will support you.
FORUT: Are there any promising news to report about alternative development in urban setting?
Yury Fedotov, UNODC: UNDOC, Germany, Peru and Thailand organised an AD meeting to discuss applicability in urban settings. It has been submitted to CND as a Conference Room Paper. We address rural and urban separately. Conduct research on how lessons can be applied. And synergies between traditional AD (mostly agricultural situations) and urban settings (support to access to markets, commercialisation of products). So, we need to continue doing this.
IOGT International: Our analyses of the current global drug policy discourse reveals eight areas of concern that need to be addressed in order to move from the present state of paralysis towards effective action. Human Rights, Public health, the UN Drug Conventions, the nature of commercial and profit interests and the alignment between addiction industries, tobacco and alcohol control, harm reduction, cannabis legalization and the legitimacy of building drug-free communities. The analyses also show that the conversation about drug policy in several areas is characterized by misrepresentations, oversimplifications and ideological instead of evidence-based assertions. In what way can UNODC facilitate a discussion that leads to implementation and action and protect governments’ decisions from the growing influence of the addiction industries?
Yury Fedotov, UNODC: Oversimplification of different views is never helpful. It doesn’t conduce to effective solutions. We need to listen to all views to expand common ground. We should not consider people with different views as enemies. That’s the value of finding consensus, which is what MS do here in Vienna. I hope it will continue to be guiding principle of our work in Vienna. Over-politicization is another obstacle to achieve solutions, and should be avoided. The balanced approach must be based on science, evidence, in line with international commitment. Partnerships are essential on this and we count on civil society for their important, invaluable contribution.
IDPC: Efforts to counter death penalty and EJKs by MS in the name of drug control?
Jean Luc Lemahieu, UNODC: The UN does not accept the death penalty with the exception of the most serious cases. Maybe my colleague can discuss.
Chief, Organised Crime and Trafficking Branch, UNODC: UNODC cannot and does not prescribe to governments how they legislate with regards to the death penalty. However, when it comes to using the death penalty for drug trafficking offences, we and other, especially the OHCHR have pronounced ourselves clearly that the death penalty can only be used for the most heinous crime. Drug trafficking does not amount to a most serious crime to warrant the death penalty. When we provide capacity building, be it in legislation or investigations of drug trafficking offences, we advise those making use of our capacity building that they should not use the death penalty in those countries that retain the death penalty. As UNODC, we are responsible for preparing the so called Kenya report on the rights of those facing the death penalty. That report provides a status update of countries that retain the death penalty and those that have abolished it. We make it very clear that we encourage those countries that retain the death penalty, to abolish it; and if they cannot, to commute the sentenced to death. The Conventions, as with other relevant conventions, provide for international cooperation to tackle the problem of drug trafficking and organised crime. When fugitives are being sought to be extradited from countries that do not have the death penalty to countries that have it, we advise countries seeking assistance to make it a condition that they will only considered extradition on condition of the death penalty is passed, the person won’t be executed.
Paroles Autour de la Santé: (…)
Gilberto Gerra, UNODC: We have a tri-level involvement. At the individual level, family and community level. Engagement of community in prevention. Our position is very clear. There is no obligation in the Conventions to criminalise people who use drugs. People who use drugs should receive opportunities, care, rehabilitation. People who use drugs are affected by health problems. These people can receive alternative responses to punishment and conviction. The 1988 convention also says that for minor crimes, alternatives to conviction and punishment. In the last ten years, UNODC has promoted a culture of decriminalisation of minor crimes and people who use drugs, at all levels.
Jean Luc Lemahieu, UNODC: Indeed, we have big gaps related to data, especially with regard to the African continent but also large countries in Asia. This is a problem. Also, periodical surveying of drug use is different from a country to the other. We have basically good data from only 20 countries updated as such. We hope more data will come forward to us. As it stands, it’s the best globally available data, however.