Side event: Modernizing drug policy: What helps and what goes against it—case studies

Organized by Fédération bruxelloise des institutions pour toxicomanes, the Canadian HIV/AIDS Legal Network, the International Drug Policy Consortium and the Piaget Agency for Development.

Jose Queiros, APDES, Portugal: Sometimes we’re antagonists with Joao Goulao. We’re friends and colleagues, but we have different roles: civil society and State. In the 1990s, the scenario was dramatic. Open drug scenes were quite widespread in Portugal. Prisons were overcrowded. We had really high HIV rates (above 40% among people who use drugs). Not appropriate system to address these challenges. There was a “social urgency” to act. We had key actors in the system that had stories of tragedy or suffering related to drug-related issues. It was a very cross-cutting issue in society. A similarity between many of them is also that they had experiences in exile during youth. Others stayed in Portugal, but were very active in fighting dictatorship. Some of the experts invited were quite anti-control. Some had studied under Foucault. People against State control. So that led people to think in a different way: maybe it’s not enough to think about evidence, there was also a particular intellectual framework. The process was quite top-down: designed by a group of institutional experts. When they were designing the system, they were basing this strategy on “humanistic” principles. Despite top-down strategy, they wanted participation. They invited people, visited local associations and communities, asked what they thought about different strategies. Very dialogue-based. The resulting policy is decriminalisation, but also, and very important, harm reduction. The harm reduction approach is what has sustained the model throughout the years. During austerity, people on the ground continued to work on harm reduction. Nice, structured, balanced laws are a positive development; but another thing is how this translates into practice. I would like to say that the State did not relinquish “control”, it sort of transferred it to medical institutions; but harm reduction interventions were very community based. In the last 5-7 years, our role has been trying to couple community initiatives with the medical institution. And to strengthen civil society action.

Richard Elliott, Canadian HIV/AIDS Legal Network, Canada: Will discuss 35 years of efforts. In the 1990s, we saw the introduction of a new framework for drug prohibition in Canada. It was presented as health legislation, but it’s heavily influenced by the Justice sector. It allows for wiggle room to make incremental advances. The law was presented as a means to translate Canada’s international obligations under the Treaties in the domestic legal order. There was some resistance to this intensified prohibition: at the level of courts and communities. Canadian courts, using the Charter of Rights and Freedoms, with mixed results, to challenge this framework. In the 1990s, we also see a surge in overdoses and HIV transmissions in Vancouver. This crisis led to community organising and a shift by local decision-makers. People started protesting in a very vocal, and creative, way. What we see then, is a series of prohibition exceptions and carve-outs: a regime for prescribing controlled substances. This happened in parallel, and underpinned by, judicial action against prohibition to access to medicinal cannabis. Legislation changed, incrementally, following judicial action. Same experience with safer consumption sites (rejection by government > unofficial community-based experiences + evidence + litigation > acceptance by decision makers > changes in legislation). Now there’s 27 consumption sites in Canada. But prohibition remains the key paradigm. In terms of cannabis regulation, clearly a result of activism and judicial action, but also political calculation by the Liberal Party to attract young people. In general, the current federal government has advanced in different sectors, but there’s still criminalisation of possession, a limitation of legal regulation to cannabis. To conclude, the changes we have seen are a result of an evident failure of law enforcement approaches, public health crises, community mobilisation, litigation (although with mixed results), the evidence-base built by new experiences. But this is greatly hindered by political irresponsibility.

Sebastien Alexandre, Fedito BXL, Belgium: Belgium is a federal state. The federal state is competent for justice; regions are competent for health and social policies. In terms of drug policies, this requires coordination. There are mechanisms to advance that coordination. But sometimes those spaces are not called into session… Some of these institutions are often not informed about drug policy developments. Ex. Royal Decree (September) not mentioned to the General Drugs Policy Cell (Public Health) until 6 months before. Institutionally, we have policy notes but not a national strategy. Brussels came up with its own, which is interesting but the legal framework limits its potential. The legal framework is from 1921… It was designed to limit opium consumption. And so the law forbids places “facilitating drug consumption” (ex. safer consumption sites). It was modified in the 1990s to allow for methadone, but it still criminalises: safer consumption sites, HAT, drug checking, and possession. The political class uses tough-on-drugs posturing for political posturing. Civil society recommendations are heard, but rarely adopted. There are no drug user unions. The country doesn’t record overdoses. Society is generally unaware of the topics and its ramifications. How to advance towards modernisation? In terms of the political game: Political class in Brussels are more progressive and try to advocate for change at the federal level, some local support for cannabis social clubs, upcoming elections; in terms of the civil society: perhaps civil society needs to utilise EU texts and recommendations to advocate for change, condemn government for not consulting civil society when making drug policy decisions, create awareness in international forums; in terms of the society: Stop 1921 campaign, events and engagement wth the media, links with Academy…but difficulty to mainstream this. Is it working? The government two weeks ago started a consultation with civil society on OST, first time a civil society organisation is invited to have a meeting with the official delegation…but inertia still.


Comment: Resilience is something that comes to mind when we hear these presentations. Politicians do not react quickly enough to challenges. It feels like our policies are completely reactive, not proactive. Why do we have to wait for disaster to strike? It takes a substantial amount of work
Answer (José Queiroz): It’s also about reframing the way we address and talk about people who use drugs. And working with medical professionals and other stakeholders to contribute to this change in mindset.

Question: Why not decriminalisation?
Answer: Caution, fear of backlash. They feel it’s pushing the envelope too far. The Prime Minister and other ministers say they’re interested in cannabis. They feel they haven’t done the “sales” job. . Popular support but pushback from other Member States. Our neighbours are also quite repressive, and that rhetoric and its impact on media. Finally, worth noting that the Liberal Party has voted on a resolution to replace criminalisation with administrative sanctions; and that has support in some members of Parliament of the Liberal Party.

Comment: Médécins du Monde has sought to create alliances between civil society organisations. Seek support beyond drug policy.

Comment: Iran has currently working on drafting new drug policies. Our laws, although amended recently, criminalises drugs. Perhaps civil society can put together ideas on how public health approaches could be implemented in different contexts.

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