by Lisa Campbell
— CDN HIVAIDS LGL NTWK (@AIDSLAW) March 14, 2014
On the final day of the CND High Level Segment, right before the Canadian Delegation presented their statement, I received a message informing me that my friend Junior had died of a drug overdose. Choking back tears, I had to force myself to focus on the task at hand in the name of advocating for sensible drug policy. In honour of Junior, I would like to dedicate this post to him, as I continue to believe that we must push for life saving services for young people who use drugs. During the CND, we have strived to be diplomatic in our calls for drug policy reform. Achieving this diplomacy is difficult when the lives of young people who use drugs are at continued risk because of ineffective drug policies. Unfortunately, the Canadian Delegation neglected to mention human rights, the death penalty for drug offences, harm reduction or reducing blood borne infections in their statement.
That being said, Canada did mention that a multistakeholder approach is essential, including engaging civil society in ongoing dialogue leading up to UNGASS 2016. Today, the Canadian NGO Delegation had the opportunity to meet with the Canadian Delegation to discuss some of our concerns at the CND. In preparation for the event, both the Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition created a briefing document titled, ”Promoting Smart Policy on Drugs: Brief to the Canadian delegation to the UN,” which was sent to the Canadian Delegation in advance of the meeting. Although we were unable to address all of the points in the briefing during the meeting, many of questions we were able to ask were not responded to by the Canadian Delegation as a result of the Harper Government’s National Anti-Drug Strategy, which limits government officials from acknowledging harm reduction as an evidence-based strategy for improving public health outcomes.
It is strange to see this phenomenon in action, but it’s not the first time I’ve witnessed official government representatives shying away from the topic for fear of reprisal. While we were able to discuss other issues, the lack of harm reduction funding for programs targeted at youth has a real tangible cost. It may seem like we are being nit picky about rhetoric, but not acknowledging harm reduction in federal policy (let alone on an international scale) means that young people who use drugs are left without services due to age restrictions and abstinence-based programs. Talking about young people and drug use only from the perspective of prevention and enforcement means that treatment and harm reduction are sidelined and do not receive sufficient funds to meet demand. In this blog post, CSSDP will be going through the briefing document point by point to outline the concerns for young people who use drugs, and also to summarize the information discussed during our meeting with the Canadian Delegation.
1. Encourage all countries to adopt a comprehensive public health approach to substance use
While this was not on the forefront of our meeting, it is essential that young people who use drugs are not further criminalized for their use. Some of the students we work with have been caught up in the justice system, often facing jail time or probation when they should be focused on their education. One of our most active students found out that his sentence is coming up (facing 5+ years potentially) right when he passed his LSAT. With mandatory minimum sentences, young people are more at risk for increased sentences if caught in an area where other underage youth are frequenting. Just because a young person uses drugs does not mean that they are a criminal, and we therefore believe that drug use should be seen as a public health issue rather than a criminal one.
2. Supporting countries’ flexibility to experiment with alternative, health-oriented approaches to drug policy
Although many countries find ways to be flexible with the conventions in order to provide health services like needle exchange, harm reduction interventions for non-injection drug users are lacking. While we still need services for young people who inject drugs, programs like drug checking have not been scaled up to be accessible to all young people globally. Drug testing kits for adulterants are often seen as “drug paraphernalia” and testing drugs for your friends or in a public health service can be seen as trafficking. While cannabis is being legalized in some states, rhetoric around “adult use” excludes young people, pushing them into the drug courts where sentencing can be just as punitive if they are suffering from addiction and are unable to maintain sobriety.
3. Respect, Protect and Promote Human Rights
Young people who use drugs have the right to access harm reduction services. Oftentimes this provision of health services can be moralized by governments, as the main arguments for drug prohibition is to “protect” children and youth, which often results in their punishment as opposed to support. While we did not discuss the exclusion of human rights from the Canadian statement during the meeting, we did touch on the issue of the death penalty being excluded from the High Level Segment Joint Ministerial Statement (JMS). Shortly after the approval of the JMS, several states came together to clarify that they were strongly opposed to the exclusion of condemning the death penalty from the JMS, but unfortunately Canada was not one of them. The Canadian delegation was very frank in addressing our concerns, stating that they had no qualms with opposing the death penalty, but that the Minister of Foreign Affairs office did not have time to approve signing onto the EU led statement calling on the death penalty to be abolished for drug-related crimes.
3. Ensure Full Access to Essential Medicines
This was the one point on which the Canadian government was all ears and very open to technical expertise from the NGOs present in our meeting. We were lucky to have Jason Nickersonfrom the Bruyère Research Institute present to speak to the Draft Resolution put forward by Thailand on Ketamine. As the predominant anaesthetic in many developing countries, Jason was concerned that Ketamine has gone “out of favour” in the international stage due to its increasing abuse in developed countries. The concern is that as drugs become scheduled and controlled in low-income countries, they become inaccessible. Canada should take a leading role in creating inclusion around access to essential medicines.
While it is important that we protect global access to Ketamine as an anaesthetic, it is also worth noting that this drug has a growing recreational use amongst youth in North America, Europe and Asia. Due to a rise in awareness by bodies such as the UNODC, there has been a reduction in supply, forcing the prices of this cheap generic medicine to skyrocket and increasing adulterants, including New Psychoactive Substances such as Methoxetamine, which can have a higher potential for overdose. In the Canadian context, as prices increase, young people who use drugs sometimes resort to changing their route of administration to injection, increasing their risk of blood-borne infections. We need to stress to member states that supply reduction does not necessarily lead to better health outcomes for marginalized youth, and that we need proper addiction services for synthetic drugs like Ketamine.
4. Promote the full engagement of civil society in drug policy discussion
According to Robert Ianiro, “involvement of civil society is critical.” The Canadian delegation stressed that it was Canada that had helped to draft the initial language of the Resolution on the inclusion of civil society. Rita Notarandrea, Deputy CEO of the Canadian Centre of Substance Abuse (CCSA), is the civil society representative on the Canadian delegation, and is a co-lead on many of the resolutions. CCSA has a long history of youth engagement in creating federally funded youth prevention programs, yet the youth that they chose to engage are not necessarily young people who use drugs or marginalized youth. In our meeting, we stressed that the inclusion of key affected populations is essential when discussing drug policy reform, such as young people who use drugs and street involved youth. While scientific data is important, young people who use drugs have on the ground knowledge of trends, including the effects of drug policy. Through the meeting, we learned that the CCSA sent out a questionnaire and presented summarized feedback from NGOs, but many of the NGOs present at our meeting did not receive it. We need civil society engagement beyond online surveys, and one that reaches out to populations affected by drug policy and meaningfully engages them in a consultation process leading up to UNGASS 2016.
5. Concerns about the language of a “drug-free world”
Statements around aiming for a “drug-free world” are not based in reality, as it is increasingly recognized that the war on drugs is a catastrophic failure. There is a great deal of evidence that indicates that rates of drug use are largely independent of drug control policies. It is time for member states to redefine the measures of success for drug policies. If the goal was shifted from eliminating all drugs to reducing drug related harms, we could focus on minimizing the negative impacts of drugs as opposed to criminalizing young people who use drugs. This “drug-free world” rhetoric leads to policies like mandatory minimum sentences which disproportionally impact youth. Party drugs popular with young people, including Amphetamine-Type Substances, Ketamine and New Psychoactive Substances, are increasingly placed under Schedule 1. Young people are curious about drugs, and we need to provide them with factual information on the harms so that they can make their own decisions and take control of their health. If the focus is only on prevention, valuable harm reduction supplies are inaccessible.
6. Role of the World Health Organization
While Canada is officially opposed to the language of harm reduction, there is still a vague reference to these evidence-based public health interventions in the JMS. This arises by referring to the WHO, UNODC and UNAIDS Technical Guide, which states that such interventions have, “remarkably reduced the number of HIV infections, with some countries approaching the elimination of injecting drug use-related transmission of HIV.” The NGOs present were interested in Canada’s specific concerns about the wording of harm reduction. The Canadian Delegation enforced the government’s commitment to the NAS, and believed that prevention, treatment, control of production and enforcement are the tools they can use to curb harms. That being said, they presented no issues to the technical guides, but were unable to address our questions as to why harm reduction itself was problematic.
On top of this important meeting with the Canadian Delegation, the CSSDP National Chair Nazlee guest blogged for the CND Blog hosted by the International Drug Policy Consortium (IDPC) for the first time today. She covered the Committee of the Whole in the morning (which covered resolutions E/CN.7/2014/L.2 and E/CN.7/2014/L.8), and a side event titled, “COPOLAD: Evidence-Based Tools and Resources Available for CELAC and EU Countries” in the afternoon. All of her posts are now available on the CND blog and have been linked for the convenience of our readers here. As is the tone of the CND Blog, Nazlee’s posts reported on exactly what was said in these sessions without adding personal reflection.
Written by Lisa Campbell, we snagged this post from the CSSDP.org blog