In many places across the world, progress toward harm reduction, decriminalization and legalization is happening. But it’s typically driven from the ground up. A number of individual nations are moving faster than the United Nations; and in turn, many regional and local jurisdictions are outpacing nations. People on the ground—grassroots activists and civil society—are providing the real leadership.
Slow Progress at the UN
At the supranational level, drug policy progress is moving slowly. In January 2019, the Chief Executives Board (CEB) of the United Nations (UN), representing 31 UN agencies, released a policy statement endorsing a public health-oriented approach to global drug policy, away from policies based on punishment and imprisonment of drug users.
“We therefore commit to stepping up our joint efforts and supporting each other,” the CEB said, “[to develop and implement] policies that put people, health and human rights at the center … and to promote a rebalancing of drug policies and interventions towards public health approaches.”
The statement described measures like investing in harm reduction strategies; addiction prevention, treatment and rehabilitation; protecting the dignity and human rights of people using drugs and ensuring their equal access to public services; offering universal health coverage for people with drug use disorders; and promoting decriminalization of drug possession for personal use.
Many UN agencies, like the World Health Organization (WHO) and the Office of the High Commissioner for Human Rights, have called for decriminalization policies in the past. But as UK charity Transform Drugs explains, the CEB statement is significant because it is the most unified call for decriminalization yet from the UN.
“Crucially,” Transform said, “the UN Office on Drugs and Crime (UNODC)—the lead UN agency on drug policy—has also endorsed the position; finally clarifying their previously ambiguous position on decriminalization.”
A rise in punitive leadership worldwide has had an outsize influence on the CND’s drug policy stance.
However, the UN has not yet adopted a uniform approach to global drug policy. The CEB statement stands in contrast to a statement released last month by the Commission on Narcotic Drugs (CND), part of the UN Economic and Social Council and its central drug policy-making body.
The CND re-affirmed its approach to use the three international drug control treaties adopted between 1961 and 1988 as a framework for controlling global access to drugs. These treaties obligate countries to establish criminal offenses for the illicit production, possession and trafficking of psychoactive substances, according to the Transnational Institute.
“Drug policies are national policies,” Contanza Sánchez Avilés, the Law, Policy and Human Rights Director for the International Center for Ethnobotanical Education, Research, and Service (ICEERS), told Filter. “Within the UN frameworks, there is a margin of error for national governments to implement their own range of policies, which differ drastically around the world. The CND provides orientation on these issues.”
Avilés explained that because the CND operates on the consensus of its member states, a rise in punitive leadership worldwide—like Rodrigo Duterte in the Philippines and Jair Bolsonaro in Brazil—has had an outsize influence on the CND’s drug policy stance.
The CEB’s overdue embrace of decriminalization—and the CND’s continued obstinance—reveal a United Nations that lags behind many individual countries throughout the world that have implemented various forms of decriminalization policies. This is the case even though the current UN secretary-general, António Guterres, previously served as the Portuguese prime minister when his nation removed criminal penalties for personal possession of all drugs almost 20 years ago.
Portugal didn’t stop at decriminalization, as the Harm Reduction International Conference in Porto heard on April 28. It also invested in other harm reduction measures, such as drop-in centers and shelters, outreach workers, medication-assisted treatment programs, and syringe service programs, as described in a report by Release, another UK charity.
“Decriminalization is not a silver bullet. If you decriminalize and do nothing else, things will get worse.”” said João Goulão, director-general of SICAD, Portugal’s service for intervention in addictive behaviors, and effectively the country’s “drug tsar.” Since Portugal’s reforms took effect, new HIV infections have decreased by over 94 percent, while overdose deaths decreased by over 80 percent.
But Portugal is not alone. For example, Contanza Sánchez Avilés explained how her country, Spain, has similar approaches. “Drug use and personal possession was never criminalized,” she said. “We have drug consumption rooms, and harm reduction services like syringe exchanges, even in prisons.”
Many other countries—a non-exhaustive list includes Argentina, Belgium, Colombia, Costa Rica, the Czech Republic, Ecuador, Jamaica, the Netherlands and Switzerland—enjoy various forms of cannabis decriminalization. And Uruguay and Canada have fully legalized.
When Regional Progress Outstrips Nations
While some national governments have moved more swiftly than the UN, many state and local governments have moved faster still. This is true in the United States, as states like Colorado, California, New York and many others have outpaced the federal government in adopting cannabis legalization and harm reduction measures. And in Britain, after Scottish lawmakers last year supported creating a safe consumption site for people using drugs in Glasgow, the UK Home Office rejected the proposal—even as they admitted it might benefit public health.
A June 2018 report co-authored by Avilés similarly described a “sub-national” Spanish model of drug reform, where autonomous provinces have made their own progress—motivated by strong grassroots activism, and often in direct opposition to the national government.
People who use drugs in Spain are still subject to administrative penalties, like fines or referrals to social services. The national Supreme Court interprets drug offenses as criminal only if they “endanger the public health.” The country has also seen the rise of local cannabis social clubs.
“Over the course of the last two decades a combination of grassroots activism, self-regulation, municipal authorizations and court decisions” have established the non-commercial supply and consumption of cannabis as a non-criminal activity in Spain, Release detailed. “This has been achieved in a piecemeal fashion with the impetus coming from civil society and has hitherto progressed in the absence of any legislation.” Spanish cannabis clubs operate as nonprofit, private-member organizations, in which people can consume and share cannabis amongst themselves in a controlled setting.
Bangladesh: Harm Reduction Under Duress
On the other side of the world, slow government responses to HIV/AIDS epidemics have prompted local communities to adopt syringe service programs to prevent disease transmission among people injecting drugs.
“CARE Bangladesh is the paradigmatic example [in Asia],” explained a Gay Men’s Health Center report. “CARE Bangladesh [a nonprofit health agency] established a pilot syringe exchange program in 1998 that has grown to reach 23 districts with ‘cautious acceptance’ from the government.”
CARE operates primarily in the Bangladesh capital of Dhaka, with a central field office coordinating over 20 drop-in centers and many outreach workers. They also provide HIV/AIDS education, abscess management, condoms and community advocacy.
The UN Office on Drugs and Crime reported that people injecting drugs and even some harm reduction workers in Dhaka are harassed and routinely arrested by police, with syringe exchange activities technically classified as “abetting” illegal drug use under current laws. This situation “has not translated into legal protection or immunity for service providers, who continue to function under an environment of uncertainty and ambiguity,” said the UNODC.
Mexico: Decriminalization in Name Only?
In 2009, Mexico implemented its Small-Scale Trafficking Law, which decriminalized possession of small amounts of drugs. But in practice, the reform has done little to reduce drug arrests in the country. The thresholds for a “personal use” quantity are set so low that people using drugs are still criminalized for over a half gram of cocaine or five grams of marijuana, and treated as “small-time” traffickers. The Center for Study of Drugs and Rights (CEED) found that in the four years after law’s passage, over 140,000 people were arrested for drug use.
“Our situation is serious because the law is very ambiguous,” Emma Rodriguez Romero, founder of Students for Sensible Drug Policy of Mexico, told Filter. “The use of psychoactive substances is not a crime, but drug cultivation, purchase, distribution, and possession are. Even though there are guidelines for how to define personal use quantities, consumption is seen as a crime, so drug users are treated as criminals.”
Authorities do not faithfully enforce existing laws, Rodriguez Romero continued. “The police abuse their authority and violate the rights of people using drugs,” she said. “They extort them under threat of bringing them before the court, even if their possession is within the personal use amount.” She explained that when police detain people, they often threaten to report a higher quantity of drugs than they actually find to extract payments from detainees.
Emma Rodriguez Romero
Mexico has, however, slowly implemented harm reduction measures over the past few decades, largely driven by the HIV/AIDS epidemic. The first syringe exchange center opened in 1988 in Ciudad Juárez; progress slowed for decades until the second center opened in 2004 in Tijuana. In 2006 the national AIDS prevention body launched a national free syringe program. In 2016, one million syringes were distributed.
International Activist Cooperation
Although progress often happens at local or regional levels, international cooperation, often online but also through events like the conference currently taking place in Porto, is highly valuable for activists. Rodriguez Romero and her allies, for example, are fighting for expanded harm reduction measures in Mexico by partnering with activists from other countries in the region.
It is this grassroots energy that will drive further drug policy reforms—not government bodies.
By working together across national boundaries, drug policy reform activists like Rodriguez Romero can tap into networks of like-minded people in grassroots activism, government and law, academia and business. This facilitates sharing of information and strategies on past successes and failures. International activist alliances can also help connect each other with resources and opportunities like grants, fellowships or donor sources.
“The greatest success my organization has had thus far has been creating the broader network of drug activists in Latin America,” Rodriguez Romero said, “and coordinating the work of young Latinx people seeking change in drug policy in our respective countries. We want to grow this network and bring together thousands of people throughout the Latin American region to create substantive change and end the War on Drugs.”
It is this grassroots activist energy, Avilés agrees, that will drive further drug policy reforms globally—not government bodies. “Civil society is more present, more powerful, and more well -funded than in decades past,” she said. “It has become a powerful actor in international drug policy debates.”