Curb Aids and HIV by decriminalising drugs, say experts

• Mary O'Hara
• The Observer, Sunday 19 April 2009
• Article history

Aids and HIV worldwide. Photograph: Cat Davison/Pete Guest

The use of illicit drugs must be decriminalised if efforts to halt the spread of Aids are to succeed, one of the world's leading independent authorities on the disease has warned.

In an unprecedented attack on global drugs policy, Michele Kazatchkine, head of the influential Global Fund to Fight Aids, Tuberculosis and Malaria, has told the Observer that, without a radical overhaul of laws that lead to hundreds of thousands of drug users being imprisoned or denied access to safe treatment, the millions of pounds spent on fighting HIV and Aids will be wasted.

Kazatchkine will use his keynote speech at the 20th International Harm Reduction Association conference tomorrow in Bangkok to expose the failures of policies which treat addiction as a crime. He will accuse governments of using what he calls "repressive" measures that deny addicts human rights rather than putting public health needs first.

He will argue that governments should fully commit to the widespread provision of harm reduction strategies aimed at intravenous drug users, such as free needle exchanges and providing substitutes to illicit drugs, such as methadone.

"A repressive way of dealing with drug users is a way of facilitating the spread of the [HIV/Aids] epidemic," Kazatchkine said. "If you know you will be arrested, you will not go for treatment. I say drug use cannot be criminalised. I'm talking about criminalising trafficking but not users. From a scientific perspective, I cannot understand the repressive policy perspective."

He condemns policymakers who argue that, because drug users frequently turn to crime to fund their habit, it justifies making it a criminal justice issue. Harm reduction both helps the addict and wider society and reduces the need to commit crime, he said.

"The one population where [Aids] mortality has been untouched - and in fact has worsened - has been IV [intravenous] drug users. It's amazing, because what we call harm reduction, such as exchanging needles, has been scientifically proven as the most effective.

"This is why I will most probably start my speech in Bangkok by mentioning the contrast between major progress achieved in decreasing mortality from Aids in the poorest countries of the world versus the total lack of progress for what is the main route of transmission in most parts of the world outside Africa."

Kazatchkine suggested that politicians feared that the public would label them soft on drugs. A doctor and respected Aids expert with 20 years in the field, he has in his two years at the helm of the Global Fund overseen some of the most dramatic improvements in treatment and prevention of HIV globally.

Since it was established in 2001, the fund has received $21bn in contributions from the world's wealthiest nations and used it to play a significant part in reducing rates of new HIV infections. It has also contributed to the distribution of much needed life-preserving anti-retroviral drugs to millions of people already diagnosed.

Alex Stevens, a senior research fellow specialising in drugs and criminalisation at the University of Kent, said tomorrow's speech would highlight many of the troubling consequences of criminal justice approaches to drugs policy.

"In many countries, serious human rights infringements are committed in the name of fighting drugs," he said. "These include the use of the death penalty for drug offences, compulsory treatment regimes that include methods (such as physical beatings) that are akin to torture, and, for example in the USA, depriving convicted drug law offenders of the right to vote."

Stevens said that, while the UK was ahead of many other countries on harm reduction, its tendency to criminalise drug users could undermine its efforts.

What is needed, Kazatchkine will argue tomorrow, is a total rethink of drugs policies. "What I'm saying is that government's function is to protect their citizens. This is why harm reduction should be supported by all governments everywhere."

Portugal's drug decriminalization 'bizarrely underappreciated': Greenwald

Rachel Oswald Published: Monday April 6, 2009
http://rawstory.com/news/2008/Portugals_drug_decriminalization_bizarrely_underappreciated_Greenwald_0406.html

Champions of harsh drug criminalization laws as the best solution to curbing drug use will be chagrined to find that Portugal’s eight year history of decriminalization has led to lower drug usage rates.

According to a new report entitled, “Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies,” while drug use across the European Union has risen steadily since 2000, Portugal, which has the most liberal drug laws of any country, has actually seen its prevalence rates decrease in various age groups since it decriminalized all drugs in 2001. Prevalence rates measure how many people have consumed drugs over the course of their lifetime.

“I think it’s bizarrely underappreciated what’s been done in Portugal,” said Salon writer Glenn Greenwald, who authored the report. Greenwald, who speaks fluent Portuguese, traveled to Portugal in 2008 to study the affects of drug decriminalization in the country.

Because drugs were not legalized outright in Portugal, violations of laws prohibiting drug possession for personal usage are now merely treated as administrative offenses and carry with them no criminal charges. Drug trafficking, however, continues to be prosecuted as a criminal offense in the country.

Compared to the low to moderate levels of drug use in Portugal since decriminalization went into effect, the majority of EU states have drug use rates that are double and triple that of Portugal today, according to the report.

Greenwald, who presented his findings at a Friday event at the Cato Institute, which sponsored the writing of the report, noted that the United Kingdom and Estonia, EU nations with some of the harshest criminalization laws, also have the highest cocaine usage rates in the EU.

“None of the fears promulgated by opponents of Portuguese decriminalization has come to fruition, whereas many of the benefits predicted by drug policymakers from instituting a decriminalization regime have been realized," writes Greenwald in the report. "While drug addiction, usage, and associated pathologies continue to skyrocket in many EU states, those problems—in virtually every relevant category—have been either contained or measurably improved within Portugal since 2001.”

Greenwald said the strongest evidence in Portugal that supports drug decriminalization is the declining usage of drugs in the crucial 15-19 age group.

In every single drug category, with the exception of the new drugs that have come into popular usage since 2001, like ketamine and GHB, teen drug use has declined. The biggest drug category declines were seen in marijuana, which saw teen drug use slip from just over 10 percent in 2001 to 6 percent in 2006.

“Drug policymakers are ecstatic about this,” Greenwald said.

Since decriminalization took effect in Portugal, deaths as a result of drug usage have declined significantly. Opiate-related deaths experienced the biggest drop, falling from about 275 deaths in 2000 to about 125 in 2006, according to information provided in the report from the Portugal National Institute of Legal Medicine.

The Portugal report, which also tracked drug usage rates outside of the European Union (the region of the world that has gone the farthest in decriminalizing drug usage), found that “by and large usage rates for each category of drugs continue to be lower in the EU than in non-EU states with a far more criminalized approach to drug usage.”

Tim Lynch, director of the Cato Institute’s Project on Criminal Justice, said, “For a very long time all of the academics, who studied drug policy, had to acknowledge one reality -- that the drug policy of the United States is the drug policy of the world.”

That premise, however, is now changing.

As evidence of this, Lynch pointed to a number of news bulletins calling for drug reform in recent months: “Canadian government tries anew to decriminalize marijuana”, “Argentine president calls for decriminalization of drug use”, “Mass. voters OK decriminalization of marijuana”, ” Obama administration to stop raids on medical marijuana dispensers” and most recently, ” Webb, Specter introduce bill to overhaul America’s criminal justice system.”

Advocates of drug decriminalization in the United States, should focus not on ideological or moral arguments in making their case, but rather, empirical evidence that shows decriminalization reduces drug usage, said Greenwald.

Greenwald said supporters of decriminalization in the U.S. have an “ideal moment” to talk about it as the political mood regarding decriminalization is now shifting in favor of reform.

According to Greenwald, much of the discussion on why drugs should not be decriminalized (the primary argument being that it will lead to higher drug usage and higher assorted drug-related problems) has been speculative. He said it was up to drug reformers to refocus the drug debate away from moral and civil liberties arguments “so that it ends up being an entirely empirical and pragmatic issue.”

Because there has been little debate on empirical grounds, which are verifiable and provable, on why drugs should stay criminalized, the “extremely unexamined” assumption that decriminalization would result in a massive increase of drug usage has become widespread and generally accepted, Greenwald said.

But with the decriminalization of drugs in Portugal, drug reformers can now point to empirical evidence that demonstrates that decriminalization has positive affects.

As Greenwald writes in the report, “By freeing its citizens from the fear of prosecution and imprisonment for drug usage, Portugal has dramatically improved its ability to encourage drug addicts to avail themselves of treatment. The resources that were previously devoted to prosecuting and imprisoning drug addicts are now available to provide treatment programs to addicts.”

“Those developments, along with Portugal’s shift to a harm-reduction approach, have dramatically improved drug-related social ills, including drug-caused mortalities and drug-related disease transmission,” the report continues. “Ideally, treatment programs would be strictly voluntary, but Portugal’s program is certainly preferable to criminalization.”

Peter Reuter, a professor of criminology at the University of Maryland, who supports the continued criminalization of drugs, provided a skeptical critique of Greenwald’s report at Friday’s event, though he did admit that “I think it is fair to say that decriminalization in Portugal…has indeed achieved its central goals.”

While non-violent drug users are no longer dealt with as criminals in Portugal, Reuter speculated that because Portuguese police no longer have to put as much effort into making a criminal arrest against drug users, they are now more likely to issue many more administrative citations for drug use, which he said served to increase, rather than decrease, the intrusion of government into the lives of private citizens.

He added, that the higher rates of drug users seeking government treatment was more likely due to the aging of Western Europe’s heroin-using population. According to Reuter, the large bulk of the population of heroin dependents first began using in the 1970’s, 80’s and 90’s and so would be much older today and more likely to seek out medical help.

“Much of what is recorded here, I think, is consistent with what I see happening in many other Western countries,” said Reuter of the number of drug users in Portugal seeking treatment.

Some cause for celebration

After years of struggle, we've finally achieved real reform. Last night the state Senate approved major reforms to the Rockefeller Drug Laws. New York will no longer use prison as a first approach to deal with drug dependency and abuse.

You have the chance to thank senators for doing the right thing by sending a message now: http://dpa.convio.net/site/R?i=Fn09A4QhAsFBXpJ6HVRw1Q..

Debating yesterday on the Senate floor was fierce, but Sen. Schneiderman did a powerful job leading the debates for the Democrats, resolutely bringing the conversation back to the science, evidence and justice that back up the case for reform.

The legislation is not a complete repeal of the laws, but these changes will make a real difference in people's lives. The reforms eliminate most mandatory minimum sentences and set aside more than $70 million for treatment and re-entry services.

You can say thanks to Sen. Schneiderman and the others who voted for reform by sending them a message: http://dpa.convio.net/site/R?i=JxeGi1d6jtlqIbe3Co28aQ..

Thank you again for your dedication and hard work.

Sincerely,

gabriel sayegh
Director, State Organizing and Policy Project
Drug Policy Alliance Network