Side Event: Moving past the divisions in order to develop humanitarian drug policies: the role of the Rome Consensus 2.0 initiative

Organized by the International Federation of the Red Cross and Red Crescent Societies (IFRC) with the support of Italy, and the C4 Recovery Foundation, the Levenson Foundation, the Knowmad Institut, the Police, Treatment and Community Collaborative (PTACC), the UNODC Prevention, Treatment and Rehabilitation Section, and the Villa Maraini Foundation

The Rome Consensus 2.0 was launched at the 63rd CND as a multi-partner initiative to promote humanitarian drug policies. The statement since then has been signed by almost 100 organisations and hundreds of people from around the world. The session will further develop the issues addressed in the Manifesto, especially on how both programmes and politics can and must overcome the false dichotomies between harm reduction, prevention, treatment and recovery. Best practices from the field will also show the crucial role of community health workers and volunteers in humanitarian assistance by tackling drug disorders with a health-centered approach, by reducing the harm and stigma at community level, and facilitating the access to treatment.

 

Dr. Massimo Barra International Federation of Red Cross and Red Crescent Societies

One year ago we launched the Rome Consensus 2.0 to improve the lives of people who use drugs and suffer from disease. We’re not asking the impossible – just suggesting a minimum standard. Sterile debate between prevention, harm reduction, treatment goes on like it can’t work together. Sometimes the term harm reduction is avoided, even if applied. We’re happy to hear some MS states clearly mention harm reduction in their country statements. Only 1/8 people with drug disorders have access to treatment worldwide – this is the real scandal. It’s clear the problems are still inadequate. We believe in the concept of the continuum of care – from prevention to treatment – to a comprehensive range of health services. There should be no discrimination. The starting point is harm reduction to keep the person alive. The change of success of the therapy is proportional to the time spent on the patient – tailor to the needs and will of the person. Above all – treatment should be available sustainable and supported by public authorities. Those who have access to treatment become less dangerous and experience improvements in their lives. The more people you treat, the less they can have a negative influence on their peers. We must continue working together with CS.

Amb. Alessandro Cortese Permanent Representative of Italy to the UN in Vienna

Consensus is a success. Hope the next event will be in Vienna. Very happy to see so many stakeholders have joined the initiative. Commend the passion and compassionate spirit – it’s a real call to action to make sure that no one is left behind. Treatment should be available to anyone and everyone. Too many PWUD have experienced the drama of seeing a friend abuse drugs – but the world drug problem is a public and social problem. Strong advocates like you, advocating for access to treatment, is necessary. Range of treatments in Italy – some unknown, some best known. We must not criminalise, legally or socially, people who use drugs. We must address stigma. It’s our duty to promote more inclusive and less judgemental responses. Civil society and citizens – the Rome Consensus 2.0 is a high and noble mission.

Ms.Giovanna Campello UNODC – Prevention, Treatment & Rehabilitation Section

In my experience, stakeholders at the international levels might look very divided – but whatever you call people who use drugs, it is possible to build. Services in Italy have an open door for when people want to come in. some MS call harm reduction services and connect them to treatment services – the services are integrated. INCB recognises this. Intl Standards on Treatment include the health of the individual – not just the end of drug use. Without NSP OST – people die. Regardless of philosophy or language, there is more strengthen with everyone working together. Frontier of services – providing consumption sites. Villa Mariani – people who use supervised consumption sites – many more than expected asked to be included in treatment and therapy.

Take-home naloxone study in Ukraine (SOS study) – “I used to think that everyone was waiting for us to die. This project shows that someone cares to save my life”. We can do this is we all work together.

Mr. Ben Levenson The Levenson Foundation – U.S.

Relieved to learn I’m not the only one that finds this a special moment in drug policy. Why I am hopeful – why the Consensus is so relevant. Massimo is a great man. 25 years ago in recovery, it can be extremely dark before the dawn. We are all know aware that we care living in a constellation of crises. End of 2020 – prescription opioid epidemic -450000 lives. Predominantly people of colour. Approx. 30% increase in year ending in September. This will worsen. Complexity only starts there – cocaine and methamphetamine overdoses as well. Only 6% of OD are associated with OUD. Compare with this the structural activities that can be overstated. Reforming American policing and drug policies has registered in the highest officers of the land. A fundamental shift is occurring. Every drug policy initiative on the ballot last November passed. We are moving drug use into health frames. Recognize harm reduction and peers. Multi-declinational recovery. Hope we do more than look to consensus for guidance – we need to implement it in our communities.

Ms. Judith Twala Kenya National Authority on Drug Abuse NACADA

Involvement of government in policies. NACADA is the national agency mandated to control and oversee rehab facilities in Kenya. Other responsibilities – provide public campaigns. Five years I have worked here – provision of services has improved. Initially we couldn’t do MAT clinics – harm reduction was not available. Excited to say on behalf of my govt – they are now supporting MAT clinics. Community based orgs are working closely with government. Taking steps forward. Example: Kenyan Government working closely with Kenya Red Cross. It is safe to provide services in this place. Access to treatment and rehab has opened. Stigma has gone down. Gov of Kenya – our responsibility is to regulate national standards. We satisfy and accredited rehab facilities so that people get quality services. Fully fledged MAT clinic in one of the biggest prisons in Kenya. Gov provides methadone and counsellors. People can now get access and mainstreamed gender responsive programs. Harm reduction programs, MAT, reproductive health services for WWUD. We are proud as a country to show we are moving forward. So much advocacy by government ministries. We are supporting our people. It is important for us to all work together. Current programs training police officers to support people with drug use problems – we want to treat them in a dignified manner and provide access to programs. CSOs and government working together to report to UNODC and AU. We are now providing telehealth services – toll free number 24 hours providing services for people with SUD. We have incorporated treatment and rehab through health insurance fund – people can access services for free, in accredited services provided by the government. We need to put our hands together to treat PWUD with dignity.

Mr. Jac Charlier Police, Treatment & Community Collaborative PTACC

Police Treatment and Community Collaborative – Global Initiative. For those in recovery world, this can be readily understood. From CJ standpoint – what does this mean? How do we work together to work with people who use drugs who are victims of crime. Police, judges, wardens, defence attorneys – we all want to achieve Rome Consensus too, with humanitarian solutions. Help people get well – people are not on the other side of the divide. Makes our communities safer. More arrests leads to more crime – which leads to more victims of crime. When people get into treatment, they stop seeking drugs. People who enter CJ system – issue of drug use is exacerbated. We have conversations about reducing crime and reducing number of crime victims. We work in justice and for justice – a humanitarian approach can break the cycle of drugs and crimes – and leads to less victims of crime – why would we not do this. The answer is yes in many languages. I ask you working in justice – lead the change in your field. We are bound to move towards a humanitarian drug policy – and look to a united future by keeping people safe by keeping them well. There are alternatives to incarceration that we are all working towards.

Dr. Raquel Peyraube Knowmad Institut / Germany – Uruguay

Its very nice and touching to hear of the changes happening around the world. However – this is not the global situation. To talk about harm reduction. Governmental delegations are acknowledging the devastating impacts of drug policies. Especially in Latin America. There is also problems with the aim of the drug free world – there has been generous time granted to those with those aims and they have not met them. It’s difficult to understand why we can’t discuss harm reduction at CND. Policy must include three pillars: supply, demand and harm reduction. strategies must address all people who use drugs. General population is stuck in a corridor – we must move towards policies that address everyone. Cannabis legalisation- we must have flexibility – not just prohibitionist model. No breakthrough in global figures in reduction death. More realistic to move towards humanitarian policies. Harm reduction must be a permeant pillar of drug policies and human rights conventions are mandatory and more important that drug policies. Its not possible to continue asking the same questions without recognising the reality of the world drug situation. Need a clear message on the failed war on drugs. Actively promoting call to humanitarian efforts. We don’t have any more time to have these debate s- we need significant global changes. The time for change is now.

Lasha Goguazde – from Geneva

Social worker from Villa Mariani: Oggey Mardi Magoryabanda: My story. Born in Rwanda – now in Rome Italy. I was very young when my mother saw the ethnicity conflict in Rwanda. She escaped to Tanzania. For me to go to school, she set me up for adoption, and I was abused. I started living a street life, I had no way to support my mother or little sister. Many years later, I found myself in Italy dealing and consuming drugs, still living a street life – I had no one to turn to for help. Until I turned to Villa Mariani – where I could get methadone. I was wanted, then got arrested, then when to prison. In prison I met the Villa Mariani volunteers again – started following their groups and finished my sentence and rehabilitation programs there. I obtained many qualifications – I became a social worker. Villa Mariani hired me as one of their workers – now I am helped those who were in the same situation that I was in. I use my experience to inspire and empower those who are living the situation that I was in. My only question is – I believe that moving beyond the division is very important. How difficult is it to apply a humanitarian aspect to drug policy.

Next intervention from Oscar Garcia, Mexico: stigma and discrimination related to substance abuse. Only 1 in 7 receive treatment. Knowmad Institute discussion paper on stigma and discrimination. We are please to be part of this group.

Camryn Rigby:  Question to Jac: 500,000 in US have died from overdoses. Numbers increased significantly in CVOID. I know you’re committed to providing care to these communities. How does the academic world successfully advocate for this?

Jac: Educational institutions: this is a call to action. Go find your local justice leaders and educate them on the neuroscience of addiction and recovery, and alternatives to conviction. Help justice leaders become educated. Tell why treatment works and recovery matters. Create a cadre of justice leaders that know and understand how to work within the connection of justice and health. Science, evidence base and research.

Q: How can we practically apply the Rome Consensus in different countries?

Raquel: Important lobby work to do. Need to have discussion with governments. Treatment, harm reduction – they’re waiting for us to fail. Governments are very important to set up harm reduction pillars. Prohibition is a global problem.

Giovanna: people need to advocate to governments – the stigma associated with drug use disorders is real. People don’t feel like resourcing important services. Science and academia, students can do a lot -PWUD have a right to health and meeting that right is productive and with good consequences to everyone.

Barra: people don’t understand the philosophy of harm reduction – it is not free drugs you can not treat people who have died – we must avoid the point of no return. Success in terms of prevention of disease. When I was young, many people had hepatitis C – then we brought in NSPs. Harm reduction works! Harm reduction saves lives. If people understand this, we can develop further and prevent a lot of deaths.

Raquel: Harm reduction includes social responses. We also work in drop-ins – people can have a shower, a meal, get an ID – there are many measures that we can give – psychosocial interventions is what we can give. People must educated in what harm reduction is.

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