Supporting recovery from substance use disorders

Presented by the USA to promote recovery from drug dependence. 

PP1: 

Debates on the use of “disease of the brain” to define “substance use disorders”
Ecuador – We ask the USA to elaborate more on the first paragraph, which seems to imply that substance abuse is a disease of the brain and I don’t know whether this is in line with the WHO guidelines.

USA – we had conversations in our informals. We didn’t want to use something too narrow, which is why we used this formulation.

France – we have a major difficulty with the 1st paragraph. We are not in a position to accept a reference that does not exist in our national concept of drug abuse. The “disease of the brain” is not acceptable to us, but we are flexible to everything else. 

Spain – We should not prioritise one aspect of drug abuse. What surprises me is that there is a mention of compassion for those affected. What is understood here – compassion for sick people, or something else? We do not think that this should be included in a resolution on drugs.

USA – On the first point we did remove “disease of the brain” in informals and was resolved with different language: “can result in chronic, relapsing conditions”. This is supported by Germany. 
On compassion, we can be flexible. Our thought was that there was a lot of stigma on drug use and we were trying to highlight those struggling with these issues as deserving compassion on breaking free from addiction. We are open to alternative language. 

India – the first formulation was on the causes, and the new one is on the effects. How can we explore this issue? 

USA – this language has been worked through. 

Issue of compassion and treatment
Brazil – suggestion to replace “compassion” with “support for those affected”. 

Egypt – I want an amendment of “evidence-based treatment” with “treatment based on scientific evidence”. 

PP2, PP3, PP4 and PP5 agreed without comments.

PP6

Russia – We propose to delete “stigma” and “discrimination” from the paragraph.

Spain – We are not sure about this. This is not a medical issue, we are now discussing pressure on individuals, human beings. And social stigma makes it hard for them to access treatment, so we want to retain this.

UK – The UK supports this. UNODC mentions “an epidemic of stigma”, so this is a reasonable term to use.

Also supported by Argentina, New Zealand and Canada. Strong support from Germany.

France – I support Spain too. Addicts are people, individuals, and there should not be any stigma.

Brazil – We prefer not to have “misunderstandings” because “stigma and discrimination” already cover this.

Russia – We manifest flexibility on this and therefore accept the inclusion of stigma ad discrimination.

Ecuador – I am not sure about whether we should mention the “economic repercussions”

USA – We were thinking about discrimination in the work place here on “economic repercussions”.

UK – We could then use “social, employment or legal repercussions”. This is agreed by others.

PP7
Brazil – Our comments are similar to previously, we want to remove “misunderstandings”.

Venezuela – At the end of the para, “use of drugs” should be replaced with “abuse of drugs”.

UK – Then with the deletion of “misunderstandings” we should remove “about the disorder” and also change the “economic repercussions” as we did earlier.

Egypt – 3rd line: “thereby contributing in the reduction of the adverse social…” rather than “helping to reduce the adverse social…”

All this is agreed by all.

PP8
No comments

PP9

Egypt – minor comment on the formulation of the text. Also, the phrasing “including youth and young adults” is confusing.

USA – the range of age here is broader in this current formulation, but we are flexible and would agree on keeping only “including youth”

France – we would like to keep the concept of “young adults”, it is clear and there are several such references in the 2009 Political Declaration. This is supported by Germany, these are two different target groups.

There is no agreement so the para is bracketed until further proposals in informals.

PP10
No comments

PP11
Ecuador – We should make this para on the registry of drug users clearer since some governments do not have registries for drug users. This should be made clearer.

Belgium – I don’t get Ecuador’s statement as then it means that stigma is only increased in some countries where registry is being done.

Egypt – I understand where both parties come from.

Russia – we would like to delete the paragraph as a whole.

China – On the whole we support the proposal because reintegrating people is one of the strategies of China. However, the formulation of this para is problematic for us since we use registration of drug users in respect for rights and access to employment. This formulation is not good, so we agree with Russia.

Spain – People should not fear about being on a registrar. We could amend a para to say that countries to have registrars should avoid discrimination.

Germany – We disagree with the Russia and China proposal to delete the para. We need secure systems and we are open to discuss.

Para is bracketed for now.

Venezuela – include “where appropriate” t

PP12
Argentina – Need for balance in this paragraph. Insert paragraph about recognising the importance considering state measures of recovery from substance disorders.

France – need a reference to human rights. Policies need to comply with human rights conventions.

Spain –  supports reference to human rights

Pakistan – agree to adding human rights. Clarify by adding “while ensureing such measures do not lead to the legalisation of illicit drugs”. Would a generic reference to human rights be more useful?

Spain – refuse to think that human rights concept will be linked to human rights.

Mexico – supports Argentina

UK – supports Argentina, Spain and Mexico

Egyptian – proposes new wording of Argentina’s added paragraph.

Pakistan – we are flexible. We are not clear about the term “substance use disorders” Also not sure what the state measures of recovery from substance use disorders. Worried that it might lead to legalisation of illicit drugs. It is fundamental that human rights is retained. Need to avoid legalisation. Can live with Egyptian proposal

Belgium – Egyptian proposal is confusing.

Uruguay – This debate already took place in the ministerial declaration. Certain references such as those proposed now were not taken on board now. Accepts Argentina’s proposal. Cannot accept Egypt or Pakistan’s proposals.

Para is backeted for now

Para is unbracketed

Egypt – new working “recognising that state measures of recovery from substance use disorders need to be in full constancy with Member States’  compliance to the three drug control conventions”

Belgium – other issues have been added in. The initial intention was to talk about human rights. LEt’s go down that path

Austria – agree with Belgium. Want to retain Human Rights

Argentina – We consider it is important to stress the human rights approach. If other delegations consider other matters important. We want human rights in there.

Pakistan – We agree with Belgium and Austria that human rights perspective is important. Compliance with conventions is also important. Support new Egyptian proposal. Measures should not be restrcited to state measures. Propose new wording.

Russia – Propose word change: “noting the importance of considering State Measures of recovery from substance use disorders from non-discrimination and equal rights perspective.”

Uruguay – Would Russia’s proposal replace previous para or in addition?

UK – Propose new wording “recognising that respect for human rights needs to inform the support provided to help people recover from substance use disorders and that the three international drug control conventions provide the framework within which such support should be provided.”

Chair – suggest we keep para bracketed

Egypt – there are now three proposed paragraphs. Issue of compliance to human rights is separate. Go back to old wording.

Chair – We can come back to this later in the informals

Para backeted

PP 13
Para agreed

OP1
Venuzeula – Suggest to make it more general.

Brazil – Support the changes. Additional proposal to replace the word “suffering from” to “affected by”.

Egypt – Support change. Change “where indicated” to “where appropriate”.

Para agreed

OP2
Pakistan – Questions what reintergration goals are?

USA – it refers to social reintergration and community input. A general expression

Spain – We have doubt about this paragraph. Its a big step backward. How can we encourage countries that they should include recovery. I thought we were already there. This is not encouragement. Want to remove the paragraph.

Pakistan – agree to delete the paragraph. “social reintergration” is not limited to drug control strategies.

OP2 deleted

OP3
Egypt – confusion about what was the objective of the resolution if we remove this paragraph.

Spain – I’m not sure what that means. This is a good resolution. Each country will implement in its own way.

Chair – we have deleted OP2.

Egypt – propose new wording.

Spain – Egypt’s proposal is unacceptable. We cannot leave anyone sick outside of the proposal

Egypt – not one said that they would leave anyone sick out of the proposal. COntrary to what he just said, it stresses the obligations of member states to not miss out any addicts.

Australia – the language was proposed by Australia. We don’t need to “reintergrate” every individual, because some of them were still integrated.

Brazil – Change the language, leave it more general due to some countries not having the specific things mentioned in the paragraph.

India – We cannot delete the words, because for some countries it does apply. Maybe we can add the words for countries so it reflect their organisations.

Switzerland – Echo what was said by india, but to accomodate Brazil we need to find new language

Spain – We don’t have regions either. The concept is the same though. The changes at the start of the paragraph “invites to consider” means something different in UN language.

Equador – support Brazil. More general paragraph. the way it is now is cumbersome. Change wording to refect this

Egypt – This language mainly applies to federal goverments. Need a phrase which gives space to consdier other structures. Proposes to take out some words.

Norway – We cannot agree that parts are struck out. We need community and NGO involvement.

New Zealand – Support Norway. We need communities and NGOs involved. Support Egypt, it needs to reflect everyone.

??? – delete all the different levels of government and put in “different levels within government”

Chair – suggest we take more time to figure out wording. Work it out later.

Para bracketed

OP4

Iran – suggest adding in words

Brazil – OP5 was deleted during informals. We prefer OP5 over OP4. Propose to keep OP5. Delete OP4.

Equador – agree with Brazil.

Egypt – Minor amendments to language.

Vietnam – take out some words.

Iran – add in an “and”

Pakistan – clarification required. Are there certain polices

Russia – Propose to not specify specifics. But social benefit was always in paragraph.

Egypt – New language suggests that laws throw up barriers to recovery. Suggests new wording around access.

Chair – suggest we bracket it for further discussion.

Para bracketed

OP5bis
Austria – not sure what this means

New Zealand – we were asked to consider some of the words, this was uspposed to recognise that individuals were the focus of recovery.

Pakistan – Agree with Austria. This means that it is not specific. It is complicated

Australia – If it read “to provide a range of services to individuals through the recovery process”

New Zealand – support Australia’s proposal.

Egypt – Suggests new language

Pakistan – what do we mean by a range of services? What do we want from member states?

Australia – clarification: the intent is to meet individual needs, there is a common process, but there are many different needs.

UK – Support Australia’s change. “it’s a menu of services”

NZ – we can do further refinement as required.

Vietnam – replace the word services.

Chair – five minute break.

OP5bis bracketed

OP6

OP6 agreed to

OP7
Egypt – insert the word “scientific” in front of “evidence”

USA – Agree with this

Egypt – intent of para is for countries to provide programmes based on scientific evidence. Para doesn’t reflect that

UK – Its not inconsistent that scientific evidence-based services that should continue to build the scientific base for the service

US – let’s bracket this paragraph

Para bracketed

OP8
Iran – Instead of “urges” “invites”

Para agreed

OP9
Agreed

OP10
Pakisatan – Not sure of what this mean. Want clarification

Venuzuela – we want further clarification about what should be discussed

Egypt – the notion of inclusion of an agenda item is up to Plenary, not a resolution. Suggest minot changes

Spain – there has to be a time frame on the exchange of experiences. No need to include a new agenda item.

Morocco – we are asking member states to share their experiences of implementing the current resolution. But it’s hard for that sharing of experiences to be put into an understandable form to the CND, suggest that it comes as a report to the the Executive Director. Change the wording so that the UNODC reports to the next session of the CND of this resolution.

Pakistan – “Sharing of experiences” is not the most appropriate way. Moroccan suggestion is good. Better wording would be “on” rather than “in”. Needs a time limit.

Break here because run out of time.