(a) Changes in the scope of control of substances
Secretary: For Item 5a on changing in the scope of control of substances proposed scheduling recommendations initiated by the WHO. It reflects comments from governments on factors related to recommendation initiated by the WHO. The Commision will examine recommendation on 12 substances as applicable to the Conventions. After the recommendation the commision needs to act with consensus. Under the 1961 Convention: a simple majority is needed. Under the 1971 Convention a ⅔ majority is needed irrespective of how many members in attendance (at least 35 members majority is needed).
Item 1 (Inclusion under the 1961 convention) – carfentanil
WHO: It is an opioid related to fentanyl with similar effects but 100 times more potent. It produces respiratory dysfunction and loss of consciousness. Linked to deaths globally. Liable to abuse and effects similar to other opioids also under the 1961 Convention. It is convertible to other very potent opioids also scheduled under the 1961 Convention. No approved therapeutic use in humans. We recommend it be placed under Schedule 1 of the 1961 Convention and Schedule 4. Its use in animals does not offset the threat to human health.
Chair: Delegation comments? Or can we move to a vote? We can take a vote.
No abstentions or votes against. Total 46 votes in favour
The Commission has declared to include carfentanil in Schedules 1 and 4 in the 1961 Convention.
Item B Ocfentanil
WHO: It is an opioid related to fentanyl and produces similar signs of intoxication including loss of consciousness and deaths have been reported. Evidence that abuse of the drug constitutes a public and social problem. It is liable to similar abuse of opioid drugs scheduled under 1961. We recommend it be place in schedule 1 of the 1961 convention.
Chair: comments or straight to a vote? I invite the commission to take a vote placing it as schedule 1. I ask those in favour to raise their country signs. I now call members of the commission not in support to raise their signs. I see none. I request those abstaining to raise their country signs. There is a total of 46 in favour, so we have decided to include Ocfentanil in the 1961 Convention.
Item C: Furanylfentanyl
WHO: it is an opioid structurally related to fentanyl and produces similar effects in individuals. There is evidence it is being abused so as to constitute a public health problem. It has no recorded therapeutic use in humans and we recommend it is scheduled as 1 under the 1961 Convention.
Chair: I invite the commission to take a vote. There is a total of 47 votes in favour, so we will include as schedule 1 under the 1961 convention.
Acryloylfentanyl
WHO: An opioid related to fentanyl – can cause respiratory disruption and loss of consciousness. It is already controlled in a number of countries. Likely to be abused and cause social problems. Liable to similar abuse and has similar ill effects as other opioids such as fentanyl already scheduled. No recorded therapeutic use in humans. WHO recommends it be placed under Schedule 1 of the 1961 Convention.
Chair: Any comments or are we ready to move straight to a vote? We can now vote to place Acryloylfentanyl under the 1961 Convention.
47 votes in favour, 0 against and 0 abstentions. The Commission has declared to include Acryloylfentanyl in Schedules 1 of the 1961 Convention.
4-Fluoroisobutyrfentanyl (4-FIBF, pFIBF)
It is structurally related to fentanyl. One country has reported 62 overdose deaths during just 2016. It is likely to be abused and we recommend it be placed under control. Similar effects to fentanyl and other opioids already placed under control. It has no therapeutic value in humans, therefore we recommend it be placed under control of the 1961 Convention.
Chair: I invite the Commission to take a vote to place this under Schedule 1 of the 1961 Convention.
Total of 47 votes in favour. The Commission has declared to include 4-Fluoroisobutyrfentanyl (4-FIBF, pFIBF) under Schedule 1 of the 1961 Convention.
Tetrahydrofuranylfentanyl
WHO: Is an opioid structurally related to fentanyl and produces similar effects in individuals. Sixteen deaths were reported in 2016-2017 and there is evidence it is being abused so as to constitute a danger to public health. It has no recorded therapeutic use in humans and we recommend it to be scheduled under the 1961 convention as a schedule 1 substance.
Chair: We move to a vote. A total of 47 votes in favour so we will include it as schedule 1 under the 1961 Convention.
AB-CHMINACA
Chair: We move to AB-CHMINACA to be scheduled under the 1971 convention as schedule 2.
WHO: The effects are in line with other cannabinoids. Between 2014-2017 deaths were confirmed and it has been placed under control in a number of countries. The risk to public health is substantial and has similar ill effects of other cannabinoids already scheduled under 1971 and we recommend it to be scheduled as a schedule 2 drug.
Chair: We move to a vote on whether to place as a schedule 2 item under the 1971 Convention.
Chair: There are 47 votes in favour so we will include it as a schedule 2 item under the 1971 Convention.
5f-mdmb-pinaca (5f-adb)
WHO – It is a synthetic cannabinoid receptor agonist. It is more potent than THC, a substance which is listed in Schedule 2 of the 1971 Convention. Cases of impaired driving have been reported. The committee found that risk to society associated with this is significant. It has similar effects as other synthetic cannabinoids also scheduled under the 1971 Convention. It has no therapeutic use in humans.
Chair: I invite the Commission to take a vote to place this under Schedule 2 of the 1971 Convention.
47 votes in favour. 0 against, 0 abstentions. The Commission has declared to include 5f-mdmb-pinaca (5f-adb) under Schedule 1 of the 1961 Convention.
AB-PINACA
WHO – It is a synthetic cannabinoid receptor agonist. Effects include loss of consciousness, convulsions and death. Cases of impaired driving have been reported. The committee found that risk to society associated with this is significant. It has similar effects as other synthetic cannabinoids also scheduled under the 1971 Convention. It has no therapeutic use in humans. The committee recommended that it be placed under Schedule 2 of the 1971 Convention
Chair: I invite the Commission to take a vote to place this under Schedule 2 of the 1971 Convention.
48 votes in favour. 0 against, 0 abstentions. The Commission has declared to include AB-PINACA under Schedule 1 of the 1961 Convention.
UR144
Chair: UR144 Schedule 2 of the convention
WHO: A synthetic cannabinoid receptor agonist. It is more potent than THC. Numerous countries have brought it under national legislation. The danger to public health is substantial. No recorded therapeutic use and we recommend it to be scheduled under the 1971 Convention as schedule 2.
Chair: I invite the commission to take a vote.
48 votes in favour, 0 Against and 0 Abstentions. Item Scheduled under the 1971 Convention as schedule 2.
5F-PB-22
WHO: Is a synthetic cannabinoid receptor agonist. It may cause loss of consciousness and cases of fatal and non-fatal intoxications have been reported since 2013. We consider the degree of risk is substantial and recognises it has similar ill-effects to other cannabinoids scheduled under the convention. We recommend it be placed as schedule 2.
Chair: I invite the commission to take a vote.
48 votes in favour, 0 Against and 0 Abstentions. Item Scheduled under the 1971 Convention as schedule 2.
4 FLUOROAMPHETAINE (4-FA)
WHO: is a derivative of amphetamine that is listed in schedule 2 of the 1971 convention. Both fatal and non fatal cases have been recorded. Effects are similar to amphetamine and methamphetamine. It has similar effects as other substances also scheduled under the 1971 Convention. It has no therapeutic use in humans. The committee recommended that it be placed under Schedule 2 of the 1971 Convention.
Chair: I invite the Commission to take a vote to place this under Schedule 2 of the 1971 Convention.
48 votes in favour. 0 against, 0 abstentions. The Commission has decided to include FLUOROAMPHETAINE (4-FA) under Schedule 2 of the 1971 Convention. There are delegations who wish to take the floor at this stage.
Republic of Korea: We continue to review new substances and abuse cases at home and abroad. Our demand reduction is as important as supply reduction. We are cooperating with the medical community, the press and NGO’s to achieve demand reduction. Every year anti-drug campaigns ae held in June. I’d like to address the medical use of cannabis compounds. We have recently had lots of public discussion on the medical use of cannabis, and the government is considering reducing legal barriers to the medical use of cannabis following a review by the WHO. We will continue to comply with the drug control treaties and contribute to international efforts.
China: We agree with the proposed scheduling of substances by the WHO. Until now China has scheduled 138 NPS. We have noted the proposed scheduling mainly targets fentanyl derivatives. Since 2016 we have tightened control over fentanyl and precursors. In 2017 we newly scheduled four substances. A total number of 23 are under government control. We have enhanced intelligence sharing with member states. We have improved investigations and seizures of outbound parcels. There is a decline in seizures however certain regions such as north American there is increasing demand.
Switzerland: I draw your attention to 3 points. We were pleased to host the INCB and note their recommendations concerning our safe drug consumption rooms. The objective of these rooms is to reduce the harmful effects of drugs. We disagree that the safe rooms should guide individuals to treatment because this must be a free and voluntary choice and can thus not be a prerequisite of these rooms. The rooms are part of a larger scale initiative as part of a holistic approach which aim to reduce the worst effects of drugs abuse. We have had these rooms for over 30 years and they have been shown to help save lives and they do help individuals access other services. They assure safety for consumption. There was discussion about the availability of drugs. We are continuing our reflection on this and whether we need to improve their availability. We would like the INCB to be more transparent including country reports. We draw attention to the six analogues of fentanyl, they have medical uses. We draw attention to the INCB draft on the export authorisation system. We would like to draw attention to our holistic approach and reaffirm out commitments to the conventions.
UK: The health harms of NPS are significant and present threats to us all. We have established the International Action Group for NPS – it is made up of 30 member states and international organisations that coordinates and delivers the international response. We thank you all for your engagement in this group and your cooperation. Significant progress has been made including on data collection and scheduling. We are encouraged to see 12 NPS placed under international control this morning and we support the decisions in this regard. With the emergence of synthetic opioids this presents a significant challenge, and we look forward to working with you all on these issues in the future.
(b) Challenges and future work of the Commission on Narcotic Drugs and the World
Health Organization in the review of substances for possible scheduling
recommendations;
Chair: To assist member states in applying existing scheduling procedures. Under the sub item the commission will address the challenge of NPS. We encourage states to produce reviews of NPS to enable prioritising of substances for review. In addition, resolution 64 invited WHO and other relevant organisations to enhance its surveillance of NPS of concern. I invite Mr Justice Teddey of the UNODC to introduce the item.
UNODC: Today there are over 800 NPS substances reported by 110 states worldwide. The risk and adverse effects on people are of global concern, following year on year increases across global markets. The rate of the appearance seems to have stabilised, the phenomenon is still adapting. Current trends indicate a decrease in NPS emerging. But significant challenges remain, the raising number of opioid based substances. The number of fentanyl analogues tripled to almost 25. A number of the most harmful NPS have been placed under international control, 12 today bringing the total number to 29 since 2015. In 2016-17 the commission in its resolutions recognised the importance of using the potential impact of toxicity and the harmful consequences helps prioritising these substances for review. The scheduling of substances remains a significant milestone and the most important aspect of protecting human kind. It depends on the ability of member states to identify new substances. The result of poor implementation challenges our collective efforts to protect mankind through scheduling. Concerted efforts on the sharing of information, including early warning systems to identify emerging threats.
WHO: The assessments of psychoactive substances are made using valid scientific data. We consider harm and usefulness of substances. There are 3 major issues being addressed. The first is NPS: major challenge is the large number of NPS on the market and their rapid turnover. We prioritise the most harmful. Most NPS data is not available. Important information is provided by member states and we encourage the sharing of information from reliable sources. We are developing a health surveillance system as requested by CND. It aims to alert member states to dangers of substances. The second issue is abuse of opioids associated with large numbers of overdose deaths. We are committed to addressing this public health problem. The ECCD has recommend a number of scheduling of opioid substances. The ECCD will undertake a review of opioid substances exempt from 1961. We will review tramadol. The third issue concerns cannabis because of the increased interest of countries of the therapeutic use of cannabis and the fact it has never been formally assessed by ECCD.
China: Illicit trafficking of ketamine has become an acute problem affecting social stability. We continue to devote attention to international scheduling of ketamine and we stand ready to co-operate with the relevant agencies. We support WHO is making positive contributions within the mandate. Last year we submitted 30 pieces of research on ketamine. We hope the WHO can share its collected data.
Japan: The international community should cooperate on NPS. It is important to share the information concerning newly found NPS concerning toxicity and effects among member states. Rapid scheduling is important. The sharing of expertise is very important. We would be grateful for support from many countries. Regarding 5C we strongly support the concerns expressed by INCB. The prescription of cannabinoids must be done under competent medical guidance. Special topics of this report is treatment of drug use disorders, we have some comments on this. INCB points out that offences of lesser gravity not being under punitive sanctions and providing treatment. The gravity of punishment and how to give punishment and treatment in a well balanced manner should be based on the legal system of each countries. It is not appropriate to have universal standards across the world. Punishment of drug abusers in our country helps the drug problem. Compulsory treatment should be discouraged however it is necessary to preventing addicts from causing harm and it is medically necessary to treat them.
US: This vote today will save lives. Over 42,000 people died in 2016 from overdoses, many of them from opioids like fentanyl. The overdose crisis presents a new paradigm facing many states now or in the future. Any county with an internet connection and access to mail is subject to this crisis. But these substances are now subject to increased regulation and will protect many people.
Item 5C
INCB: It is an honour to present the INCB annual report. The annual report has a special focus on the linkage of human rights and drug policy. We emphasize the importance of non-discriminatory access to treatment. Treatment is cost effective and better than criminal justice system. It should be seen as an element of the right to health. Currently only 1 in 6 people in need to treatment has access to treatment, and stigma remains an obstacle to access to treatment, rehab and social reintegration. We need to make treatment services accessible, improve collaboration with civil society, and reducing stigma and discrimination. On the recreational use of cannabis – any nation that permits the use of cannabis for non-medical use is contrary to the drug conventions. On drug consumption rooms, we reiterate their objective must be to reduce the consequence of drug abuse without condoning it or trafficking. It must also refer to or provide treatment, rehab or social reintegration. We continue to consult with the government of Afghanistan. We call on the international community to support Afghanistan. 2018 marks the 70th anniversary of the Universal Declaration on Human Rights. We continue to emphasise that success needs to be consistent with human rights standards. We need to protect children from drug abuse, and trafficking in drugs and precursors. We encourage all states that retain the death penalty to consider the abolition of the death penalty. The global consumption of opioids has been increasing. We draw attention to the global pain divide. The use of cannabis for medical purposes is permissible under the 1961 Convention, as long as it is subject to scientific research, trials and supervision. On NPS we report on sharing information in real time – we do this from our special platforms and global networks made up of 125 countries. In 2016, 73 substances were reported through IONYX. Illegal internet pharmacies are a global phenomenon and we are assisting government in addressing this challenge. We are upgrading the IDEAS platform that provides reporting and monitors treaties compliance bases on information provided by government to the board. It has been in operation for 14 years, and is in need of a major overhaul. The 2017 precursor report provides an overview of the action taken by you and the board to deny traffickers access in chemicals used in illicit manufacture. It notes the growing sophistication of traffickers in obtaining precursor chemicals.