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Informal Dialogue with the INCB President

International Drug Policy Consortium: In May 2018, the INCB invited civil society for an informal discussion around medicinal cannabis. This was a very positive step to ensure that civil society could raise critical issues with the INCB. Could you inform us as to whether you are planning any future similar consultations with civil society?

Viroj Sumyai, INCB: The Board has already discussed this issue at the February session. And we will continue our work with civil society like we did last May session. This year, during the May session, we want to hear from you about young people and drugs. This is the issue that we want to get some detailed information from civil society. From advocacy groups from grassroots level on the situation on the ground concerning young people and drugs. It’s scheduled that we would conduct this session.

INCB Secretariat: We have a tentative date but we will write to the VNGOC about it.

Asociación Proyecto Hombre: The 2018 World Drug Report launched by UNODC revealed that women represent one third of the world population who takes drugs. Nonetheless, historically, the percentage of women in treatment for substance use disorders are significantly lower. The 2017 Annual Report of the Observatory of the Association Proyecto Hombre in Spain indicated that only 15.7% of the patients in treatment were women. From the monitoring role of the INCB, what policies should the Member States and civil society promote to improve accessibility of women into health system.

Viroj Sumyai, INCB: INCB is concerned and has made recommendations on the matter. INCB tackles issues of concern in a thematic chapter of our Annual Report. Chapter 1 of the 2016 Annual Report dealing with the topic of women and drugs, including a series of recommendations to Member States. One size does not fit all. Gender sensitive treatment must be provided. Women are the ones who take care of families; this is the task that they find themselves performing, so we need to take special attention to this. With regards to treatment rehabilitation and social reintegration, we note that stigma is the most important barrier for seeking treatment. INCB encourages governments to take the necessary steps to promote and increase access of specific populations including women. I particulary, we encourage governments to take into consideration specific circumstances of women and challenges, so as to address obstalces. Governments should also addess demand reduction efforts in a differentiated manner according to gender.

For Alternative Approaches to Addiction, Think & do tank (FAAAT): Given that we are seeing more police and soldiers in USA commit suicide than die in the line of duty will the INCB be looking critically at the use of prescription medicines for PTSD that carry a suicide warning label?

Viroj Sumyai, INCB: We look at this issue with concern, and we look at our mandate with regard to this issue. The INCB was accused at times of overstepping our mandate when talking about this issue. This is the mandate of WHO, to look at this issue. We will try to talk with our counterparts at WHO

International Center for Ethnobotanical Education, Research & Service (ICEERS): In Spain there are 2 prominent associations of therapeutic and medical cannabis users advocating for their right to use cannabis for these purposes, but there has never been a governmental or official cannabis program in the country. At the same time, 2014 INCB Annual Report provides guidelines to States that want to implement medical cannabis programs on how to do it without.

Viroj Sumyai, INCB: According to 1961 Convention, cannabis for medical purposes is allowed. The decision on whether to implement a medical cannabis programme is the prerogative of the country. WHO as the international expert body on health is the right body to consult on the medical use of cannabis. Yesterday morning, there was a deliberation of the scheduling recommendations on the cannabis issue. IT is up to the Spanish government to decide whether to implement. The Conventions do not prevent the government from allowing use. The knowledge and expertise is already there, in many Spanish institutes. And even within the WHO, who can give consultations and advise to the Spanish government if it decided to open these programmes.

International Drug Policy Consortium: For most UN agencies, reports from country visits and other events are made available in the public domain. Could you explain why this is not the case for INCB sessions and INCB country.

Viroj Sumyai, INCB: When the INCB conducts a country mission, it is conducted by 1 board member and one member of the secretariat. They take note from what they hear and also from civil society. From those working notes, when we travel back to Vienna, a country mission report is written. That’s the report. In that report, there’s raw data discussed in the field. So, from the part of the Board, the country is different level of openness. Even governments within themselves, health, prison, etc. they work independently and they give information to the INCB. And then also civil society gies information to the INCB. That information is raw data that has to come back to produce a country report. From that country report, we submit it to the Board session. The Board examines this report and from that examination, the main findings and recommendations are provided to the counterparts in countries. But for the main report, we cannot make it public because if you understand the situation in many countries, you will understand the point of confidentiality. Given to civil society and government. It’s a matter to protect  civil society and government officials. Also, according to the 1961 Convention, under Art. 9, this is the way INCB conducts its business. We have to keep confidentiality at some level and then communicate with member states on specific points that we might want to assit them with regarding the international drug control system. Sometimes, there’s a tension between transparency and confidentiality. We get information, like a company that receives trade information and cannot release it because it’s sensitive.

VNGOC: The VNGOC arranges for civil society to participate in these visits and it’s a fantastic opportunity and a great experience. We encourage you all to make use of this.

IOGT International: Mr President. We have seen some Countries breeching the Conventions and also the statements from the INCB. In your opinion, what tools should INCB need to have more power? Is it possible or what obstacles can you see?

Viroj Sumyai, INCB:  The tool is already there in the 1961/71/88 Conventions. You have to understand the mandate of the INCB. We’re a quasi judicial body. We decide what’s right or wrong according to the Convention. But in terms of action, this is a prerrogtative of MS and CND. We make an initiatl decision, MS decide whether to continue, and we need to inform State parties. According to the Conventions, we have to keep this process confidential. We cannot make Member States lose face with the situation. But we will continue to do our work with the utmost care and we will see. We don’t need other tools, they’re already here.

Community Alliances for Drug Free Youth: As you know, WHO has looked and reviewed and analyse the cannabis situation and submitted recommendations. We’re concerned they may have made a mistake in their calculations on cannabinol and how much THC might be in it. They looked at a GW Pharmaceutical product before it was diluted and put out to the general population. That calculation they did was made on the pure product diluted tenfold. So it is unclear in the document and I encourage you to look at that and make sure it’s not the case.

Viroj Sumyai, INCB:  In terms of the WHO-ECDD recommendations, with regards to cannabis and cannabis products, that’s the results from the ECDD meeting in last November. INCB participated in the ECDD meeting as observers. We have no right to make interventions with regard to whatever they discuss. We can provide the ECDD only the Convention’s perspective of scheduling. On the final day, they come up with recommendations, and we are not allowed to sit on that meeting. I will look at this issue. We get some legal perspective from legal advisors before that paper came. In their first paper, they mentioned pure CBD; but there is not a chemical that is absolutely pure. So, the new recommendation doesn’t talk about pure CBD.

ENCOD: The international control system has to include human rights approach. How to avoid bad practices and how is the INCB warning parties to ensure the protection of those rights.

Viroj Sumyai, INCB:  This is a standing point for INCB. On the issue of the criminal justice system, we have voiced our concern about the principle of proportionality when imposing sentencing. With regards to capital punishment, INCB, even though in the Conventions, it is the prerogative of the government to judge the severity of the crime; we ask governments to respect human rights, already 70 years old. We are on the same boat as the UN, so we all must go in the right direction. The UN does not allow for capital punishment for drug offences. According to international standards, capital punishment should be avoided. If the sentence is already handed down to the prisoner, we suggest the government commutes it to life imprison or something else.

John Walsh, WOLA: I was hoping the INCB could state clearly its views on compliance or not of the US with regard to cannabis and the treaties, particularly towards non-medical use. The INCB view on the noncompliance on non-medical use is clear on nations that have changed their laws but what is their stance on the US, where the national law hasn’t changed, but subnational jurisdictions have changed their legislation.

Viroj Sumyai, INCB: The issue of the US with regard to recreational cannabis is an issue of state law enabled by some poll. For the federal government, the law, the Controlled Substances Act, schedules cannabis. It prohibits cannabis. So it means the state is acting on their own decision, against federal law. I always discuss with the US authority. INCB has a dialogue body. The situation is like when you have a big family. The US has 51 sons, 51 states. You have 10 stubborn ones. What are you going to do with your sons? The federal government must impose some measures on the stubborn child. The federal government does it already. If you read the news, you realise the government is taking measures. We continue to be in dialogue already. These measures are the results of ballots. We encourage them to solve the problem and give them advice.

Brun Gonzalez, INPUD: MDMA, psilocybin and LSD are currently scheduled internationally as having no therapeutic potential. In the US, Czech Republic and Switzerland, we’re seeing some of them approved in treatment. What would be the steps to launch a critical review and reschedule accordingly on the basis of this new data?

Viroj Sumyai, INCB: For medical and scientific research, even with scheduled ones under the 1971 convention, the government can allow scientific research. The government has to issue a permit to the researching body. That’s the first step. For an in-depth analysis like cannabis’ critical reviews, that’s a responsibility of the WHO-ECDD. Without thorough and systematic research, there cannot be a critical review. My point of view… I teach clinical pharmacology. There is a sign that it could be beneficial but we need to take care of clinical design, very carefully; to make sure it doesn’t represent a burden on the recruits for the trial.

Sergio Sánchez, Latinoamérica Reforma: What kind of recommendations does the INCB give to countries allowing for medical uses of cannabis but at the same time doesn’t have a framework to regulate what kind of cannabis products will be accessible for the population (pharmaceuticals, vs flower)?

Viroj Sumyai, INCB: Medical cannabis doesn’t mean the flowering top of the cannabis plant or the leaf itself. But the active constituent that we extract from that plant. Smoking the cannabis plant is not medical cannabis. You may allow people to cultivate cannabis in their own home, and then make remedies by cooking with home utensils and produce oils, and use for therapeutic purposes; that’s not a medical cannabis programme. This is the recommendation that the INCB gives to Member States. INCB Annual Report 2019 – Chapter 1. We will try to come up with guidelines. I have instructed the Secretariat to convey an expert group meeting to come up with guidelines on the suitable way to conduct cannabis plantation, how to process products, etc. It will come out soon from INCB.

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