Special event: Drug policies in the Americas

Amb. Adam Namm, CICAD/OAS: (…)

Roberto Moro, SEDRONAR: We welcome the report Secretary Namm just mentioned. We’re building policies based on evidence allowing us to make policy decisions adapted to our countries. Working beyond UNGASS, these guidelines should continue help us develop and build strategies. It’s a complex work if we take into account all recommendations, specifically the UNGASS. We need political will to implement them. Many countries are trying to find balanced approaches too and place the individual, not the substance, at the centre; working on gender equality. We congratulate Mexico, who occupied the previous presidency. Left us pending issues, we’re working with that. We’re working with US, our successors. Regarding work on bilateral cooperation, that’s where the response lies. Looking at best practices. Having a best practices agenda in the region. Ensuring international bodies coordinate agendas so that countries strengthen what we’re developing. For three years, we have been working on this. At the different ministries, we have been working on this. Many of those here have helped us make this assessment to ensure an impact on public policies. We all want the best possible response; there’s no single solution. But we should bear in mind scientific evidence and plan so that our results are better and better. We’re pleased to work in a hemisphere where we work together a lot. CICAD puts a lot of tools at our disposal. We work with all our energy and commitment to ensure the best possible response. Thank you all who contribute. Shared efforts and responsibility will deliver results.

Brian Harris, United States/Vice Chair of CICAD: I’m very excited about the report on drug use in the Americas. We’ve agreed to work as a hemisphere and as international community to be guided by evidence. Particularly now as we try to keep pace with developments, data is important to face challenges. Data can be a challenge in and of itself so we welcome this initiative. Drug use in our hemisphere remains a health and security threat. The drug problem has become increasingly global. It has become increasingly interlinked. Synthetic drugs, particularly opioids affect us in one way or another. We must avoid these unnecessary deaths. Not enough to collect data but also sharing information about trends and efforts to address them. The US supports the revision of the ARQs. A consolidated repository of our knowledge can enhance and enable UNODC’s and our common response. The US welcomes this. You’ve heard us talk about the challenges of the opioid crisis. More than 70,000 deaths. 190 deaths every day in the US. A real impact on a macro level. Life expectancy in the country has declined fuelled by this. Shocking magnitude across all levels of society. We want our experience to be a cautionary tale. It’s mostly a public health challenge but we’re not sparing efforts. Some of our lessons: Emergency scheduling of fentanyl related substances, (…), youth prevention, safe storage and disposal. We’re also here to learn from you and how to keep our citizens safe. Just as much as we share information, we should share evidence based responses. Looking forward to CICAD exchanges in Buenos Aires this May. National and regional experiences informing international tools. Our region is informed and guided by the CICAD Hemispheric Strategy and Plan of Action. (…) As we look to develop a new hemispheric strategy, it’s easy to feel overwhelmed. But in my country, the crisis might be turning a corner. The rate of overdose seems to be plateauing. It’s not victory, but reduction in misuse of prescription and increase of MAT and naloxone.

Marya Hynes, CICAD: This report is the culmination of three years of work by CICAD and our team. Before I go into the results, I want to say a few things. It’s the work of national observatories that made this possible. It consolidates reports on populations: general, secondary school students and university students. It takes a lot of time from countries. I’ll now consolidate 3000 pages in 5 minutes. Highlights: 11 countries have trend in use data in secondary school: early onset of drug use is a problem and we’ll see it in younger and younger population; but also different uses by esx; and new challenges. Cannabis use is increasing among secondary school students in most countries, even as tobacco use declines. We do not have data from every country on e-cigarettes, though. When it comes to cocaine, half of the countries show also increases. Substance use is increasing in the youngest populations (high school students – ½ binge drinked over the last 2 weeks / 5 or more drinks). IN terms of regular use, half binge drink. Prevalence might be low or high, but half are binge drinking. A surprising finding, sedatives without medical prescription higher among women in every population. Different patterns of use. Very important to think about the nonmedical use of prescription drugs Is highest in countries with the lowest illicit drug use. Makes us question what we consider “drugs of abuse”. Inhalant use is legal usually, higher among women; generally not considered main focus but high impact on a particular population. I would challenge you to look at your data on inhalant use among high school students. NPS appearing in the region (NBOMe, fentanyl, synthetic cannabinoids, others). Not in rates that appear in national population, but in early warning systems.

Ministry of Security (Argentina): There’s a strategic decision in Argentina to control precursors. We’re seeing many countries establishing more effective strategies dealing with the logistic chains of the organisations. We are looking to seize assets but also impact logistic strategy. With the exception of some narcotic drugs, at a certain point in processing, a chemical is required. If states can work together to control and regulate the legal market, we will have taken a decisive step in this battle. Those not familiarised with the expert group we chair at the CICAD; I can tell you that the expert group is a technical team to exchange information and best practices. It’s made up of experts of 15 countries and non-country experts who bring professional experience. Important in terms of understanding these over and beyond the interests of states. During our leadership, one essential point is to implement the chemical production of drugs regulations. An excellent opportunity to implement dynamic mechanisms of multilateral control. Important to exchange experience of regulatory mechanisms in each country. WE have adopted policies and laws on precursors. On borders, we have legislated on diversion of precursors; a way to impact the organised crime organisations. Our aim is to give control tools to the State that take into account new production methods. Considering the dynamism of the NPS market. States need to respond to this challenge. This review will take place under the 3X session of CICAD in May. The result will be the work presented during the meeting of experts in Buenos Aires. This is Argentina’s perspective regarding this function at CICAD.

Ministry of National Security (Bahamas): Our geography brings together countries that are primarily consumers with primarily producers. Playground to play hide and seek for those involved in trafficking. And countries with limited resources to counter those practices. Area vulnerable to maritime trafficking. Aware of the impact of narco-trafficking on communities and individuals. False economies. Threats to financial services. Potential of blacklisting. Undermining governance. Impacts the health and social consequences too as a result of drugs in the population. Payment in kind. Shipment countries. It impacts our relations with other countries too. Recently I mentioned to colleagues, that my job is to facilitate their job. A large part of what I do is about what they say needs to be done. The Maritime Narco-trafficking expert group and the supply reduction of CICAD does the same for their MS. Works with MS on general drug enforcement, customs work, maritime cooperation, etc. Increase capabilities to respond to new threats or problems. This intercountry approach is vital to response to maritime trafficking. In the side event yesterday, on coordination on drug policy, it was stressed that members need to commit to this. Bahamas currently chairs maritime group on narco-trafficking. The attendance during the last five meetings reflected just a few meetings. Not being around the table is a missed opportunity to contribute to annual action plans. Glass is half full. To boost attendance, efforts will be made to contact stakeholders in their countries to encourage attendance. Canvas international stakeholders with maritime concerns. Encourage local stakeholder agencies to reach out to their regional counterparts.

Diego Olivera (Uruguay): Target 3 defines our aim in designing implementing and strengthening programmes in development at the rural, urban level including comprehensive and sustainable development, and if appropriate, preventative. Let me remind you that on the same issue, at the UNGASS, we defined our commitment to deal with the economic aspects of the production of drugs and the manufacture production and trafficking of drugs implementing long-term programmes and orientated towards balanced development. Also, the outcome document welcomed the 2030 agenda and we observe efforts in this direction are complementary and mutually reinforcement. At the level of CICAD, this is what we’re doing. In the outcome document, there’s a chapter on AD. These priorities actions are define: exchange experiences best practices, evaluation and research, monitoring, State presence, participation of local society and civil society, urban development policy, promotion of alliances and innovative strategies with private sector. As Chair of expert group on AD, programmes on illicit trafficking are a priority. We shouldn’t forget impact of small trafficking. WE should focus on problems of people. We need to respect local culture and the active participation of civil society both in the debate of policy and implementation of decisions. Development is of key importance to the Americas, particularly if we consider our region has the highest level of inequality. We neeed to strengthen interagency work.

Canada: We have hosted expert meetings on implementing recommendations of the outcome document. Policymakers must adopt gender perspective. Effective responses demand governments consider a broad range of factors including impact of race, gender, sex and age. Canada applies a gender based analysis to all domestic policies. Integrating equality considerations into our projects. Including building capacity of member states. We welcomed cooperation under CICAD to cooperate with MS to dismantle criminal organisations. The evidence is clear, the full integration of all individuals in the security sector can improve the overall performance of the sector. Domestically, Canada has adopted new approaches in drug policy under four pillars: prevention, treatment, harm reduction and enforcement. Partially to respond to ongoing opioid crisis. Adoption of harm reduction measures to save lives and reduce harms. Greater access to treatment, strengthening prevention, law enforcement tools to interdict toxic substances. During the Plenary we’ll explain some of these. I will focus on drug impaired driving laws. Legislation was passed to strengthen criminal laws on the matter to mitigate challenges on regulation of cannabis. 3 new criminal offences. Investments 81million dollars in 5 years to build capacity of officers to enforce laws (funding on sobriety testing and drug recognition exports). Investments in a “Don’t’ drive high” campaign). We continue to support the work of CICAD.

Vice Minister of Justice (Colombia): Few points on our anti-drug strategy adopted last year. Challenges for us: growing problem in the consumption of drugs, number of crops cultivation (and pollution, displacement, poverty associated), money laundering, asset laundering, diversion of chemical substances. Our antidrug policy has four pillars: reduce consumption of drugs and impact (most important pillar because our country has become a consumer country), reducing supply and availability, dismantling criminal organisations, affecting the economies and assets of criminal organisations. All this around principles based of integral comprehensive nature of policy. When we review the situation of consumption we find that alcohol consumption has been reduced, but alarming increasing in tranquilisers without prescription, cocaine base paste, cannabis, NPS, cocaine, etc. We have put the family at the centre. The whole policy aims to protect children and teenagers; trying to avoid that a whole generation of young people is harmed. Also minority populations, including our indigenous populations. We are seeing a problem of consumption affecting adults and the elderly too. We must take urgent actions at all levels: schools, communities, workplace. I’d like to bring to your attention that we’re facing a problem of killings of social leaders. When we look at the number of murders, it’s the coca production areas. Coca is a destabilising factors. In terms of asset laundering, 40 billion pesos. Unless we fight illicit flows, drug traffickers will continue to use these capitals to by consciousness. Finally, yes, we need to act at the level of the territories, but unless with create permanent conditions to help our citizens to move towards legality, we won’t achieve change.

Isaac Morales, Ministry of Foreign Affairs (Mexico): This event is a real scale event regarding benefits of developing synergies at regional level. I want to highlight some of the products of CICAD: Dialogue – we have produced a mechanism of evaluation that doesn’t shame but creates opportunities. We reaffirm multilateralism that way. Plurality – Respecting differences, we recognise different challenges and common responses. Inclusion – The participation of experts from Academy, other international organisations and NGOS in debates of CICAD have become a constant reality and a mandate. Adaptation – From CICAD, we have been able to tackle concretely specific themes that are important for the acknowledgement of evolving realities through working groups, expert groups and thematic panels. This work is sufficiently flexible to even deal with subjects like legal regulation, decriminalisation of use of drugs, proportionality of sentencing, alternatives to incarceration, how to tackle NPS. Taboo issues become key issues at the heart of CICAD. We have been able to advance international commitments; even at a quicker pace than international spaces. Mexico, to implement UNGAS, welcomes the support of CICAD. WE have organised seven national dialogues, plural dialogues, that have given us two ideas of action: attribution of responsibilities to implement operative recommendations, involvement and dialogue with experts. That way, we’ve reached an integral and balanced approach. By having a clear picture of the state of illicit markets, nationally, regionally, hemispherically and internationally, we can update and strengthen policies. Part of our conclusions in the national dialogues, on the specific case of prevention, treatment and rehabilitation, Mexico has assimilated the concept of integral prevention. Not only prevention of drug use but all elements affecting communities and vulnerable groups affected by the world drug problem. Mexico walks towards a better integration of the public health approach, distancing itself from prevention-only approaches; including harm reduction, gender, development, and an overarching perspective. We’ll gladly share these lesson with the international community.

Alejandro Corda (CEDD): Are there plans to produce reports like the one you just released but focused on the negative impact of criminal justice in the region?
Adam Namm (CICAD): We have a strong alternatives to incarceration programme. More than 50 alternatives to incarceration that we have identified. We have published a report on evaluation. It’s a very important component of what we do. More than 1/3 of OAS members have alternatives to incarceration measures, included drug treatment courts. Many member states now feel it’s an important part to address this.

Katherine Pettus, IAHPC: I was surprised not to hear about access to controlled medicines. The supply control emphasis of policies can hinder access. Chapter 4 is an incredible advance to CICAD. The MEM mandates reports on this. It would be great to hear someone reflect on that.
Adam Namm (CICAD): It’s important and something we have discussed in the Secretariat in the last couple of regular sessions. It is an issue. In certain countries there is not enough access for palliative care.
Brian Harris (United States / CICAD): In the US, we have bene laser focused on getting the opioid crisis under control, but we have also discussed, when discussing scheduling, how that manifests itself on hindrance to access. There’s anecdotal evidence on a chilling effect that suggests that scheduling leads some countries to take medicines off the market. But there’s no reason for that to be the case. As an international community, we need to talk more and more about implementation of scheduling decisions. We need to make sure that if a country has no capacity to implement regulatory controls, we contribute to it and avoid them taking the substance off the market when they have medical value.
Isaac Morales (México): We have a programme to ensure access to palliative care and improve prescription practices. Health professionals do not sometimes prescribe opioids because of stigma and fear; so we will continue working to avoid that. The good news is that it’s part of our strategy and we will be obliged to present data on progress or the lack thereof. Hopefully it will encourage cooperation on the matter.

(Brazil): Would it be possible to hear a bit about access and control to medicines? What can we do to facilitate access and control non-medical uses?
Marya Hynes (CICAD): Our current surveys are not the best vehicle to identify this, so the report does not discuss this issue; but we will definitely explore this possibility in the future.

Natacha Lopvet (EQUIS Justicia): I was imprisoned for years for a drug offence. I have heard of your plans for the future. But have your countries considered the release of women for non-violent crimes next month, next year; an action now.
Brian Harris (United States): Our country adopted correction practices in the 1990s that have meant the incarceration of important numbers of nonviolent offenders. We are now a leader in implementing alternatives to incarceration, such as drug treatment courts. We have passed a “First Step Act”, which will also move in that direction. I’m not an expert on this challenge and gender; but I know we’re moving towards a new model that is not the punitive corrections model.

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