Side event – Amphetamine-type stimulants: Working towards humane drug policies

Carl Hart (Columbia University) discusses ATS and scientific evidence. Photo by Sanho Tree
Carl Hart (Columbia University) discusses ATS and scientific evidence. Photo by Sanho Tree

Welcoming Remarks: H.E. Gen.Nivat Meenayotin, Vice Minister of Justice, Thailand

Visionary leader, leading role in women prisoners….results in betterment of women prisoners.formulating drug laws on proportionality of sentencing, Bangkok rules, human treatment of women prisoners and offenders. Counter ATS expertise.

 

Chair: Associate Professor Dr. Apinun Aramrattana, Faculty of Medicine, Chiang Mai University, Thailand

Growing and expanding ATS market, especially in South East Asia where they are among the most commonly used illicit drugs.

Drug policy in SE Asia continues to focus on punitive policies.

New initiatives in Thailand will be presented.

 

Professor Dr. Carl Hart, Columbia University on “(Meth) amphetamine: Fact vs. Fiction and Lessons from the Crack Hysteria”

Methamphetamine -What does the evidence tell us?

Difference between Amphetamine (used to treat ADHD, weight and narcolepsy, many armed forces use to keep soldiers awake)

There are claims that methamphetamine is highly more addictive but data does not support that. This is the case with most drugs.  About 5-10% who use methamphetamine will become addicted.

However, when you bring people to lab research with addiction as defined by DSM,they behave rationally. If offered a hit of meth vs. 20 dollars which will be worth more than what they were receiving in the quantity of meth; 8 out of 10 times they are offered they will chose the money. If you have sufficient alternatives people will take the alternatives. This has been found with other drugs eg. Cocaine.

There are also concerns with psychosis and violence, however the scientific evidence does not prove this.

When you have a sufficient dose, more than 20g, you see an improved cognitive functioning. Back in 2012 reviewed cognitive functioning when taking methamphetamine. Methamphetamine users perform just as well as control group on cognitive performance. Some literature has made misinterpretations, however.

Our research has not found anything anything related to violence and literature is not convincing.

Methamphetamine disrupts sleep and food intake but this can be addressed with adequate sleep and food intake.

We know drugs are not the problem but other social factors such as employment.

 

Ms. Gloria Lai, Senior Policy Officer, International Drug Policy Consortium on ‘ATS, harm reduction and associated global and regional drug policy developments”

IDPC is a global network of civil society organisations. Gloria is based in Bangkok in Thailand, Asia.  It advocates for evidence-based dialogue, human rights, public health and development. It stands for a harm reduction approach to drug policy.

Available data- reports from UNODC. South Asia, South East Asia. Rapid report of seizures 2008-2013. In terms of youth, huge market of ATS. Largest number of people who use ecstasy

Policy responses: In Asia some of the worst policies as drugs are viewed as a moral evil. This perspective justifies incredibly punitive measures. Examples of penalties in Asia – Disproportionate response especially in comparison to other laws. Mandatory death sentences. Forced urine testing, corporal punishment, compulsory detention centres, sites of torture and forced labour as reported by HRW.

But harsh penalties to deter people who use drugs are not successful.

This is not a shrinking the market in Asia. Prison populations are growing. Rates of imprisonment for drug offences growing. Rates of methamphetamine related arrests rising 2009-2014 for some ASEAN countries.

Govts. Pay little attention to scientific evidence. Why are we imposing such harsh penalties, if they are not effective? …other than political expediency.

Some adoption of harm reduction in response to HIV epidemics including some needle syringe programmes. But understanding of harm reduction is limited, and some countries only relate this to HIV which is concerning. There’s still little understanding of the harms of ATS use.

Decriminalisation of drug use: the removal or non-enforcement of criminal penalties of drug-use. It is accepted as best practice and encourage. Countries should remove of all penalties including administrative penalties.

For countries not ready there are diversion measures that could be implemented.

 

 

Dr. Alex Wodak, President of the Australian Drug Law Reform Foundation on “Australia’s Experience of (Meth) amphetamine Control”

National context-1985 adopted ‘harm minimisation’ defined to mean supply reduction plus demand reduction plus harm reduction. But government expenditure 66% on drug law enforcement, 21% treatment, 9% prevention and 1% harm reduction.

The language around the issue in Australia is also detrimental.

1990-2008: 38 homicides Melbourne of methamphetamine traffickers.

Corruption not being discussed at UNGASS.

Australia developed problems with methamphetamine while it was using heavy reliance on law enforcement

2nd most commonly used drug in Australia ,70% of users , use less than once a month. And ice use in Australia is very high in international comparison. 91% of people who use drugs say obtaining ice is easy/very easy

We can’t arrest, imprison our way out of this problem. But growing awareness of drug education which is unlikely to help much.

Difficulty getting treatment help for ice, roughly takes 10years to get help from the time of first use.

Response 2: 2015 increased funding for treatment of stimulant user. 2016 NHMRC funding for lisdexamfetamine trial. Substitution treatment like methadone. Extended release preparation. Active when taken orally, inert if injected.

Drug consumption room-Sydney (2001) no violence experienced with Ice.

Clearly big contribution the context people are in

Conclusions: Big problem in Australia, though alcohol problems are much greater; meth problems evolved while Australia mainly responded to drugs with law enforcement; need for a more realistic assessment; too little drug treatment, poor funding.

 

Associate professor Sakchai Lertpanichpun, Criminal Justice Program, Faculty of Social Administration, Thammasat University on Thailand’s Experience of (Meth) amphetamine control”

Thailand is well known as a country with the most severe drug laws in the world

Problems with Thai drug laws: Theory and attitudes (Retribution/deterrence/incapacitation rather than rehabilitation); theory of criminal law-making ATS to be narcotic drug (even though they are different)

Other problems? Imports. Case study of women who bought tablet of 1.5 meth into Thailand for personal use, served 25 years in prison and was fined  14,000 U.S. Dollars

In population of drug offenders

Changes in punishment-light to sever punishment-20 years to death penalty

Change in ATS price

Change in prison population, 80% of prison population are ATS inmates -6th largest in the world

Out of 100% female inmates, 80% of female inmates, related to ATS

 

Draft of new narcotics code, a new hope for solving drug problem. 2015 Thai ministry of justice has initiated the compilation of essential Thai drug laws so called narcotics code. Draft approved

  1. Classification of offenders-users/addicts/dealers and role of dealers
  2. Imposition of punishment: Light/harsh punishment, depending on personal use; eliminating the irrefutable presumption on drug possession for sell.
  3. Consideration of offenders social background
  4. Use non punitive measure rather than punishment

 

Crucial roles should be seriously considered

  1. Role of public health professional in the quality of treatment system
  2. Roles of related law enforcers in enforcing new code with justice and transparency
  3. Roles of public prosecutors and judges
  4. Roles of communities in drug abuses

 

Anxious about drug abuses but we should be considered with power abuses.

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