Side Event: The Rome Consensus 2.0: Towards a Humanitarian Drug Policy

Organized by the Government of Italy, the C4 Recovery Foundation, the International Federation of Red Cross and Red Crescent Societies Partnership on Substance Abuse, the Levenson Foundation, the Police, Treatment, and Community Collaborative, The Villa Maraini Foundation, the UNODC Drug Prevention and Health Branch and the World Health Organization

Dr Massimo Barra, Chairman, Partnership on Substance Abuse IFRC: I have been involved in the world of drug abuse for 45 years. What has happened in the last year? The people of goodwill from various countries are concerned with the increasing impact of substance abuse on the happiness of humanity and have decided to combine their knowledge and experience to provide the Rome Consensus- humanitarian drug policy. We are asking for your support and subscription. We would like to inspire anyone who works in the field of drugs to follow the principles of this consensus. It is our common purpose to improve the lives and conditions of those abusing drugs. We have a new terminology: ‘sick for drugs’. We are fully aware that not every drug user can be considered ‘sick for drugs’ but it is not acceptable anymore for those that are actually living in this condition to be considering criminals, sinners or even just bad people. The strategy of worsening instead of improving the living conditions of those sick from drugs, expecting punishment will keep them away from drugs, is a harmful solution costing billions of dollars and needless suffering. Punishment and therapy cannot coexist.  Evidence shows that all the people sick for drugs have problematic behaviours, posing risks for themselves and others around them. Those that want to undergo nonviolent treatment are less dangerous and have a greater chance of experiencing improvement in their life. Evidence shows therapy is a long path – the chance of the success of the therapy is always proportional to the time spent in treatment. A quick cure does not exist. Treating people sick for drugs should be a common interest for all governments and citizens. We aim towards a humanitarian nonviolent perspective, violence always brings violence – it does not improve the living condition of the drug user nor the people in the world who do not use drugs. We only want compassion for those who made unfortunate life choices. 

Mike Trace, Former UK ‘Drug Czar’ – Moderator of the session: In the last 5 years I have observed significantly more movement than in the last 20. It is not a clear and simple movement, but i believe we are in a period of modernisation of drug policies and the primary movement is away from punishment of drug users towards social and compassionate approaches. This is professionals around the world speaking to policy makers. Those signed up to the consensus are professional bodies. If you want to implement this change paradigm then you can implement it in various ways. You can find our consensus online and can sign on. 

Ms Masci, Social Worker – Italian Red Cross/Villa Maraini Foundation: I am a social worker in the field of substance abuse and i have been working at Villa Maraini since 1992. I began taking drugs at the age of 13, i tried so many drugs but my beloved one was heroin – I was about to die of overdose. I went through the crushing experience of stigma during incarceration, where I also found out I was HIV positive. During this time I met a social worker from Villa Maraini, who made me think differently, who made me feel meaningful and treated me as a human not as scum. After a few years I made it, I stopped using drugs, unfortunately my friend, my mother, did not make it. I then realised my mission – I was lucky to get out of it, and so for nearly 30 years I have committed myself to helping others day and night – especially working on the street with those who do not want to quit, those who are hard to reach. The very first contact in the street is crucial in my job, because harm reduction is the first step on the path to the therapy. Our strength has always been the humanitarian approach. Avoiding judgement and punitive behaviour – leaving an open to door anyone. I am here to give a voice to those who are struggling with the sickness and can’t be here with us. Any decision concerning our lives cannot be made without directly involving us. For this reason the Rome Consensus is an important piece of work to change the approach towards a humanitarian one. Any drug addict can quit and no human beings are illegal.

Dr Gerra, Chief of Drug Prevention and Health Branch UNODC: Drug policy should treat people with a respectful and compassionate attitude. Avoiding unnecessary punitive and counterproductive approaches. The 2016 UNGASS document speaks of the same principles as the Rome Consensus 2.0. We have a serious problem at this point, that the member states have approved the UNGASS document and have not adopted it, this shows that nothing is moving. There seems to be a collective denial position – I will be speaking on this in the plenary this afternoon. This approach to make the affected people feel guilty, those that are happy to pay for any sort of thing for healthy people but not for those affected by substance disorder. I was managing a treatment centre in the 80s, using harm reduction to try and save those in the street (Villa Maraini). The monetary situation is there. 100,000s are losing their lives, millions developing disabilities, catching HIV and Hepatitis and the highest toll is paid by the poor, affected by the inequalities of their situation. We are sick of drugs but also sick of vulnerabilities. What we could do – we need a large scale movement to translate in practice what has been written in the UNGASS document.  

Red Cross Georgia: We want to mitigate the human suffering of all, independently of political bias. Substance abuse remains a major cause of suffering and among those who suffer the most are the users themselves. Many are imprisoned rather than treated. For a very long time Red Cross and Red Crescent have called for a more human approach to fighting drugs, which does not rely on the persecution and punishment of drug users. This is based on a strong sense of humanity but more importantly well documented evidence. The UNGASS document called for the implementations to reduce health risks that are people-centred and inclusive to minimise public health and social consequences of drug abuse, to not uphold the inhuman and degrading punishment and eliminate punity. The Rome Consensus is signed by 121 international societies. Building upon the success of the Rome Consensus no. 1, the primary goal of number 2 is strengthening relations amongst the Red Cross institutions, civil societies, harm reduction practitioners etc. We must not find it hard to reach communities. We provide methadone substitution therapy, and aim to use science to increase people’s knowledge and awareness. We must bridge the gap between formal health institutions and the most vulnerable. 

Dr Vladimir Poznyak, Coordinator – Management of Substance Abuse WHO: WHO welcomes the Rome Consensus as it maintains WHO’s main aims. We want a more balanced and comprehensive approach as highlighted in the UNGASS 2016 document. It’s in line with WHO’s strategic direction, universal health coverage and the moto ‘no one is left behind’. Ihe focus of the Rome Consensus – Red Cross and  Red Crescent endorsed the first Rome Consensus 15 years ago – where the shift away from the criminal justice approach was not so prominent. I understand why the 2005 document contained statements which became prominent later in drug policy – this is because it was composed by those working on the front line, understanding what it is like on the ground. We have multiple documents produced in and outside the UN system promoting messages reflected in the Rome Consensus. But is is surprising how many messages of the 2005 Rome Consensus resonate with policy discussions now. We are doing everything possible for equal access to life saving treatment for those who have drug disorders. We must use ethical and science based preventive interventions. This consensus not only reconfirms 2005 humanitarian drug policy but also calls for implementation of these policy directions. We should walk the talk – make sure your actions are not far from your words and intentions. The Rome Consensus 2.0 calls upon all of us to walk the talk. 

Mike Trace: The last two speakers are from the USA. Before they begin, let’s’ remember the USA was often the cheerleader of punitive drug policy with a punishment focus in this arena.

Ketie Sherman, The Levenson Foundation: Thank you for your time and interest in this important Side Event.  My Name is Katie Sherman, I am the Vice President of Drug Policy for The Levenson Foundation.  Mr. Levenson, Chairman of The Levenson Foundation and Mr. Ohrstrom, Chairman of C4 Recovery, both key non-profit sponsors of today’s event and The Rome Consensus 2.0 deeply regret not being present with us on this historic day.  Coincidentally, they both had family members fall quite ill just prior to their departure and had to make the difficult choice to stay home and care for their loved ones. Contrary to popular historical accounts, there were pioneering harm reduction endeavors, including peer-led needle exchange programs in the US as early as the late 1960’s. They were informal, neither legally sanctioned or science-based, but born out of human need and humanitarian compassion.  Sadly, that brief spark of enlightenment proved to be a false dawn. In 1971 President Richard Nixon initiated the “War on Drugs,” declaring drug abuse “Public Enemy number One.”   As most of us know, draconian drug interdiction policies and severe mandatory sentences for even minor possession and use were introduced.  A forty-year era intentially naïve of research and drug use reality overtook America wherein still today, in key quarters, we continue to reject health and person-centered strategies due to ideological obsession with abstinence as the dominant pathway for people with risk-based relationships with intoxicants.  Stigma became structured and enshrined and a largely privatized prison industry has grown exponentially increasingly disproportionally populated with ethnic minorities and the poor.  As of February of 2020, drug offenses comprised some 45% of all the incarcerated individuals in the US. Combined, Mr. Levenson and Mr. Ohrstrom have worked in the field for 55 years around the World and both have new found hope that we may stand on the cusp of meaningful, long-term change.  Shamefully, it has taken a devastating Opioid epidemic, impacting  all stratas of American society to lead to a collective moment of potential Sanity. There has been profound and promising change in some American attitudes over the past five years.  One feature which is different is the Law Enforcement community, one which previously helped lead the War on Drugs and Drug Users, are now forcefully co-leading a sea-change.  Never did we foresee a day where we would sit, accompanied and supported by Law Enforcement officials, in front of Congressional policy makers and advocate for humanitarian treatment for people who use drugs.  We are at a hinge of history, but like all hinges it can move to open or shut the door. That is why today is so very important.  We need to keep pushing – nothing as complicated and emotive as this issue can be taken lightly. Mr Levenson and Ohrstrom commend Massimo and the fabulous teams who had the courage to take a brave stand more than 10 years ago with the original Rome Consensus.   Now is the time for us to build on that initial momentum.  We believe The Rome Consensus 2.0 document accomplishes this, concretizing the fundamentals necessary for humanitarian treatment and an enlightened empathy for those who may be suffering.   Please join us and support it with all your heart.

Jac Charlier, Executive Director, Police, Treatment and Community Collaborative: Each year in the United States, our police encounter approximately 56 million people in the course of their daily duties. Following these encounters, police are left with two choices: 1) arrest or 2) take no action. Yet, this is a false binary because it does not match the reality of who the officers are encountering, what the person encountered needs, and how the officer should proceed next when they are the first to say that something needs to be done to help this person. For example, it is estimated that 60-80% of police encounters in the United States, when we look back on them, are either in part or entirely social service related as the basis for the contact with the police in the first place. Into this situation then that is repeated over and over and over enters the newly emerging practice of deflection and pre-arrest diversion. Let me now briefly tell you about this long overdue and very much needed collaborative movement in the United States that we are bringing globally as part of The Rome Consensus 2.0. My name is Jac Charlier. I am the co-founder of and Executive Director for the Police, Treatment, and Community Collaborative (PTACC), and we are pleased to be a founding partner of The Rome Consensus 2.0.  PTACC is the voice of and knowledge leader for this newly emerging field of deflection and pre-arrest diversion. PTACC is comprised of 40 national and international organizations who come together to grow and develop the entire field of deflection and pre-arrest diversion. PTACC’s mission is to strategically widen the range of options for police to deflect people into treatment, housing, and social services at the time of contact between the police officer and a person. This then is deflection, police connecting people to treatment – in the community and without use of the justice system, instead of arrest where appropriate, and instead of taking no action, where that is appropriate. Another way to understand this is that deflection is a third-way for police: 1) arrest, 2) take no action, or 3) deflect. There are many goals and purposes of deflection, but for today’s United Nations 63rd CND, the most relevant are to quickly get people into treatment and then ultimately into recovery, while also promoting family health, safeguarding children, avoiding racial inequities, and reducing crime. So what does any of this have to do with The Rome Consensus 2.0? The answer is actually quite straightforward. At PTACC we believe that those 56 million police encounters can each be turned into 56 million OPPORTUNITIES to connect people to treatment, housing, and services in their own community.  Put another way, by formally giving police something different to do than what they normally do when they encounter people who are using drugs, they can play their part in bringing about a humanitarian drug policy. Totally understanding that the police are used and viewed differently around the world, where deflection can be started, having a police officer take somebody to treatment instead of jail and working alongside treatment instead of shunning them, will, over time and with many thousands of deflections taking place, absolutely change the narrative on police seeing deflection not as something for others to do, but as something that they should be doing because they are the police. That is how the police, through adopting the practice of deflection as part of The Rome Consensus 2.0, can and already are doing their part to move us towards a global humanitarian drug policy. Thank you. I look forward to your questions and invite you to join The Rome Consensus 2.0.

Mike Trace: We are hearing more governments and within the UN as well adopting and repeating this message, including at the top of the board of executive directors of the UN. This is quite knew This was not what was being said 5-10 years ago. 


Q&A

Q. International Doctors for Healthy Drug Policies: The problem is in the implementation – Red Cross: what measures do they plan to put in place to make sure all their own national bodies will implement this around the world?

Dr Barra: Honestly, we [Red Cross] are not the first in the world to be fighting drugs. Because we are generalists. All issues of human suffering are the task of the Red Cross, including floods, famines, wars. So we are a powerful organisation but if we compare to the needs of the world, we do very limited actions, frankly speaking. We dream for an alliance between practitioners who are there to help drug users, and politicians, and NGOS – which give commitment. We can put the power of the Red Cross, that is the power of humanity – if we put together our power we can really improve the quality of life. This is why we present the Rome Consensus. 

 

Statement: Spanish Red Cross: In our addictive behaviour intervention plan we have an aim to save lives and change mentalities. I think together we can save lives and change mentalities. 

 

Q. Kenya, National Focal Point on Drug Abuse: You mentioned the police aiminging to connect people to rehabilitation – what are their chances of success in rehabilitation? There are better chances for success if you volunteer for rehabilitation.

Jac Charlier: When we talk about deflection, in the majority of deflection there are no criminal charges. The person themselves can say they don’t want to enter treatment. There are situations where an office could criminally charge a person and does not, but instead gives access to rapid treatment to the person. In those cases, where there are possible charges, you are being offered rapid treatment instead of arrest. There are few consequences if you choose not to do it, though there are some initiatives which will aim to motivate those who are not keen. Law enforcement is acting as a referral to treatment, it is not an oversight body with a punishment element. 

Mike Trace: Success rates research is extensive: what we have learnt over 20/30 years is that when police or judges refer people to treatment, the theme is that the individual is the decision maker in their own treatment. This is not just a human rights issue or accepting agency of that person, it is about success rates. Forcing people to treatment through the criminal justice system means the partner is not part of the process. If the person chooses to participate, the success rate is much better.

 

Q. Rachel Wright, Journalist. What are the next steps, what do you hope to do together to implement the Rome Consensus. 

Dr Barra: The Rome consensus can remain an academic exercise of a few people or become a powerful tool to change behaviours across the world. This is entirely dependent on everyone who is involved in this field. We need to establish a follow up – this starts now! You can sign online, and spread the word. The opposite of harm reduction is harm increase and this is not good. There is a thinking behind the harm increase, if the damages of drugs is increased, the drug user might then be convinced to stop, but this doesn’t work. The more you treat a drug user badly, the more they turn to their drug use for relief.

Dr Poznyak: The practical steps; when we visit those involved in treatment, care and harm reduction services we can make the consensus statement available as a pack of documents that may guide their practice. This is something practical developed with UNODC. We will see how many entities will join the movement – they will form a new platform for promotion of humanitarian approaches in treatment and services. These are immediate outcomes without any follow up activities. 

Dr Gerra: We should be knocking on the doors of government and asking for humanitarian policies. Ask who is managing the problem! In 60% of countries around the world, drug  policy is part of the Ministry of Interior, Justice or within the police. Ask governments to move it out of here and into public health. 

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