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  • A gift to the drug kingpins: and the need for a North American Drug Policy Agreement

    A gift to the drug kingpins: and the need for a North American Drug Policy Agreement

    This article first appeared as an op-ed in the National Post, April 21, 2014

    We know the stories. Hockey bags that go south full of B.C. bud and return full of Latin American cocaine. Elaborate underground tunnels at both the U.S.-Mexico and U.S.-Canada borders. Canadian mobsters being gunned down in Mexican resort towns. Unlikely Mennonite drug mules crossing North America’s borders with illicit packages concealed in gas tanks and old farm equipment.

    It’s easy to think it’s always been this way, but the reality is we can thank the North American Free Trade Agreement (NAFTA) for much of this activity. So this year, while business leaders and politicians fete the 20th anniversary of NAFTA, drug runners and cartels will be doing the same.

    It shouldn’t come as a surprise. Free traders wax poetically about the interconnected, globalized economy, and the whole point of NAFTA was to strengthen the economic integration of Canada, the U.S. and Mexico by reducing trade barriers.

    How’s this for economic integration, then? Access to legal, regulated medical marijuana in Canada and the U.S. has reduced black market demand across the continent. This phenomenon will become more pronounced with the recent legalization of recreational marijuana in Colorado and Washington, and more states to come. It’s worth noting too that concerns over drug gangs generally, but Canadian gangs in particular, were a key reason Washington voters supported legalization in that state. Regardless, marijuana farmers in Mexico have responded to decreased black market demand by shifting to poppy cultivation. This has resulted in a surge of cheap heroin availability at a time when heroin use is increasing in both the U.S. and Canada.

    Yet despite the predictability of this kind of domino effect in a continental economy, then-U.S. president Bill Clinton forbade U.S. negotiators from discussing the illegal drug trade in NAFTA talks. Years later, U.S. Drug Enforcement Administration official Phil Jordan revealed: “We were prohibited from discussing the effects of NAFTA as it related to narcotics trafficking, yes.” As a result, “For the godfathers of the drug trade in Colombia and Mexico, this was a deal made in narco heaven.”

    Indeed. NAFTA brought a proliferation of maquiladoras — companies operating in duty-free free-trade zones— to the north of Mexico and a massive increase in cross-border commercial traffic. In other words, freer movement of goods in a continent that represents “the world’s largest illicit drug market” according to the UN Office on Drugs and Crime. NAFTA also brought an influx of cheap, subsidized U.S. crops — including corn, soybeans, wheat, cotton and rice — resulting in the collapse of northern Mexico’s agricultural sector. Some farmers shifted to marijuana, which is 1,000 times more lucrative than corn, pound for pound. The rest were in need of work.

    Basically, NAFTA helped create ideal conditions for the rise of a lucrative cross-border drug and gun trade.

    Governments responded by escalating the war on drugs, with devastating impacts on citizens and their communities throughout North America. An estimated 100,000 Mexicans have died or disappeared in drug-related violence, and the U.S. has the highest prison population in the world with over 2 million citizens behind bars. Of these, roughly 500,000 Americans are incarcerated on any given night for a drug law violation. At the same time, death from overdose and HIV/AIDS among injection drug users has taken thousands of lives in the U.S. and Canada. Add to all of that the pain of the families of those directly affected and the communities that have suffered these losses.

    Twenty years after NAFTA’s signing, it’s time to finally acknowledge the drug market is a part of our integrated economy. In turn, we need to negotiate a modern, 21st century drug policy that addresses the health and safety issues across the region and undermines the illegal profiteers.

    The good news is, there’s cause for optimism. The Organization of American States in particular is providing refreshing leadership through member states like Mexico, Colombia and Guatemala calling for a discussion about alternative approaches to the enforcement-heavy war on drugs. And some jurisdictions are implementing bold new paradigms on their own. Similar to the moves in Colorado and Washington, Uruguay became the first country in the world to authorize a legal, regulated market for adult cannabis use.

    The current overemphasis on criminal justice approaches to drug control in North America has sidelined a variety of programs that can minimize the harms related to the drug trade and substance use, including public health promotion and prevention programs. It has also curbed economic and social advancement for drug-producing countries.

    A North American Drug Policy Agreement could serve as a powerful statement of shared responsibility in addressing the trans-national drug problem. Such an agreement should include provisions for the consuming countries (U.S. and Canada) to reduce demand through social development and improved access to health responses. But it should also map out a legal, regulatory control framework for drugs that are currently illicit. This would reduce the violence within the drug trade, and all of the other prohibition-related harms that are far more destructive to communities and countries than substance use itself.

    Yes, it would mark a departure from 40 years of restrictive, prohibitionist policies, but as Stephen Harper himself has noted, “the current approach is not working.” It’s time to try something else.

  • To ticket or not to ticket – Conservatives take a tiny step on cannabis

    To ticket or not to ticket – Conservatives take a tiny step on cannabis

    For a split second, the door to drug policy reform in Canada opened ever so slightly. But then Justice Minister Peter MacKay was quick to slam it shut: “We’re not talking about decriminalization or legalization.”

    On March 5th, MacKay announced that the federal government is looking at changes to the Controlled Drugs and Substances Act that would make it possible for police to issues tickets for possession of small amounts of cannabis.

    The announcement follows last summer’s resolution from the Canadian Association of Chiefs of Police asking the federal government to consider ticketing options. But it also follows Justin Trudeau’s considerably bolder endorsement of cannabis legalization. So I can’t help but wonder if this is a move to stem the Liberals’ rise in the polls.

    MacKay’s proposal would allow police to issue tickets to people possessing less than 3 grams of cannabis. It’s a positive move in one way, because it means these cases will no longer be sent to criminal court. So otherwise law-abiding citizens will not be burdened with a record of criminal conviction, which can have serious implications for travel and employment.

    But it also comes with the potential of a significant downside. In Australia, for example, similar measures resulted in a “net-widening” effect. That is, because it was easier for police to process minor cannabis offences, individual officers shifted away from using case-by-case discretion in giving informal cautions, to a process of formally recording all minor offences. The result was a significant increase in formal infractions, but no change in the pattern of cannabis use.

    Still even if we assume MacKay’s changes hold promise, we need to be clear that these modest steps are not the endgame to a much needed overhaul to drug laws in this country – especially considering that jurisdictions bordering Canada are moving toward legalization. Is this is best Canada can do given the momentous changes taking place around the world?

    Critics of legalization take pains to point out that cannabis can harm the health of its users. Of course it can! So can alcohol, but the lesson of alcohol prohibition is that an underground market is an unsafe market. The purpose of a legally regulated cannabis market is to ensure that we use the painful mistakes of alcohol and tobacco regulation to create the best possible approach to cannabis. Regulation rather than prohibition will make this substance safer, control its production and distribution, and ensure that at least some of the profits go to the public coffers.

    The other problem with cannabis prohibition is that the effects of drug laws are inequitably applied to poor and Indigenous Canadians. And prohibition doesn’t keep cannabis out of the hands of kids. As Unicef’s 2013 report on the well-being of children in rich countries reveals, Canadian youth use the most marijuana compared to our economic counterparts around the world. Yet they use the third least amount of tobacco. What accounts for this second stat? A solid, legally regulated market that relies on stringent controls and education about the harms of tobacco.

    It’s great that MacKay has taken a first step, but we need to keep moving toward a saner, safer approach to cannabis use. The CDPC is committed to talking with Canadians about the possibilities of cannabis regulation. To that end, in the coming months we’ll unveil proposals to help to build a regulatory framework that takes into consideration what we’ve learned from public health approaches to alcohol and tobacco. Canada can do better.

  • Harm Reduction Comes of Age in Canada, or Does It?

    Harm Reduction Comes of Age in Canada, or Does It?

    This post first appeared in the Centre for Addictions Research of BC’s blog Matters of Substance.

    The Supreme Court of Canada’s September 2011 decision allowing Vancouver’s supervised injection site, Insite, to keep operating was a critical milestone for harm reduction in Canada.

    One only has to look at the list of interveners in the case in support of this innovative service to see that it has become a valued and mainstream service in Canada. Canadian health organizations including the Canadian Medical Association, Canadian Nurses Association, Canadian Public Health Association and 11 others saw fit to come before the court to support Insite. But even with this high level of support, scaling up harm-reduction services in Canada remains a challenge.

    Harm reduction gained traction as a result of the HIV/AIDS crisis in the early 1980s and played a critical role as a strategy to engage injection-drug users in HIV prevention. Harm reduction’s more recent challenges have elevated the critique of policy-related harms – harm caused by policies that criminalize people who use illegal drugs.

    Harm reduction acknowledges that there are significant risks associated with illegal drugs and also attempts to work towards mitigating harms within the criminalized environment where drug use occurs. This often puts the public-health goals of engaging people who use drugs in conflict with traditional public-safety strategies that rely on disruption of illegal drug markets, and in turn disruption of the lives of people who use illegal substances.  Harm-reduction approaches balance these realities and focus on creating safer environments as much as possible within a context of criminalization. Some examples include promoting supervision of consumption or discouraging using drugs while alone, promoting rapid response strategies in the form of peer-delivered naloxone programs and strategies that work towards achieving a kind of détente between health efforts and enforcement practices. Given the context of criminalization, a key goal of harm reduction is to maximize the benefits of public-health interventions and minimize the harm of drug use and the enforcement of drug policy.

    So what should Canada be doing to facilitate the development of a more robust harm reduction approach as a part of a comprehensive response to drug use? We urge governments to begin with a review of current drug policies to determine the benefits and harms to individuals and communities that accrue from the criminalization of drugs and the people who use them.

    Other countries have done such an analysis and have decided to eliminate criminalization as a response to possession of drugs for personal use in an effort to maximize the benefit of a public-health approach to drug problems. Portugal (2001) and the Czech Republic (2009), are two examples of jurisdictions that have taken this step. Both have decriminalized all drugs that are deemed to be for personal use. Portugal decriminalized drugs as part of a response to an HIV epidemic and high rates of drug overdose. The Czech Republic did the same as a result of an extensive evaluation of the previous policy of criminalization. Evaluation of the experience in Portugal has shown that results have been positive overall – HIV incidence and overdose deaths have been reduced, police are supportive of the new law as it has given them more meaningful and helpful involvement in steering individuals towards health services, more people are accessing treatment and other health services which were improved as a part of the decriminalization policy. Additionally no negative trends have been seen in terms of increased harms attributed to this policy change.

    Achieving a policy shift as significant as decriminalization will take some time. In the meantime, the Canadian Drug Policy Report, Getting to Tomorrow, outlines some possibilities for improving the development of harm reduction in Canada in the short term:

    • Acknowledge that harm reduction is much more than supply distribution and is an essential component of a comprehensive public health response to problematic substance use that offers client-centred strategies with health engagement at their core.
    • Acknowledge that harm reduction values the human rights of people who use drugs and affirms that they are the primary agents of change for reducing the harms of their drug use.
    • Provincial governments can commit to articulating harm reduction strategies across mental health, addictions and infectious disease policy frameworks.
    • Where harm reduction language is present within policy frameworks ensure implementation at the community level.
    • Support innovation at all levels. An ethic of experimentation will help create an environment where new ideas and novel approaches can be developed and explored.
    • Provide leadership to bring health and policing agencies together to get “on the same page” with regard to harm reduction. Opposition by some in the policing community is unfortunate and an unnecessary barrier to scaling up harm reduction programs.

    Developing a robust and equitable harm-reduction approach for Canadians will necessitate new thinking about old strategies — thinking that exposes the harms that flow directly from our current policy frameworks and will open the door to new ideas and approaches that are emerging around the world.

  • The Road to 2016 – Drug Policy Consensus Shattered

    The Road to 2016 – Drug Policy Consensus Shattered

    There’s a Crack in Everything – That’s How the Light Gets In (with thanks to Leonard Cohen)

    I couldn’t help it. Sometimes my mind would wander while attending the Commission on Narcotic Drugs (CND) meeting in Vienna – the annual drug policy palooza where UN member states gather to shore up the failed prohibitionist policies of the past. Even an unanticipated Russell Brand appearance could do only so much to enliven the sessions.

    In those mind-wandering moments, I found myself humming Leonard Cohen’s famous song “Anthem,” especially the beautiful line: “There’s a crack in everything, that’s how the light gets in.”

    I suppose my mind wasn’t so much wandering, as it was synthesizing the stark disconnect between the evidence presented at the outset of the meeting – in fact, the science at the heart of the enterprise – and the actual decisions arrived at by CND delegates.

    There is unquestionably a crack in the consensus in these global discussions, a crack that may well end up being a chasm as wide as the Grand Canyon by the time the UN Special Session on Drugs (UNGASS) takes place in 2016 in New York.

    Decriminalization

    As for the light, that came in part from the two stellar UN-appointed scientific panels that reported out at the beginning of the meeting. Michel Kazatchkine, UN Envoy to Eastern Europe and Asia on HIV, and Nora Volkow, Director of the US National Institute on Drug Abuse, chaired panels that delivered strong statements on the need for problematic drug use to be dealt with as a public health issue not a criminal issue. Kazatchkine’s group noted: “Criminalization of drug use, restrictive drug policies and aggressive law enforcement practices are key drivers of HIV and Hepatitis C epidemics.” Volkow’s group added: “We consider that criminal sanctions are not beneficial in addressing substance use disorders and discourage their use.”

    The divide between the above statements and the content of the negotiations at the CND was vast – the overwhelming majority of delegates clung to the status quo and refused to even consider language on decriminalization. Clearly we’ve made very little progress since Portugal (2001) and the Czech Republic (2009) decriminalized all drugs for personal use, on their own without fanfare or bringing it up at the CND.

    Harm Reduction

    In a somewhat Orwellian turn of language control, a number of countries including Canada demanded the words ‘harm’ and ‘reduction’ not appear side by side, but they could endorse “measures aimed at minimizing the negative public health and social impacts of drug abuse that are outlined in the WHO, UNODC, UNAIDS Technical Guide.”

    Harm reduction, in other words.

    These programs are the most cost effective way to engage people who use drugs and often the only bridge to more mainstream public health services. The scientific panel offered clear statements on the benefits and cost-effectiveness: “Harm reduction interventions are good value for money, with average costs per HIV infection averted ranging from $100 to $1,000.”

    Apparently scientists can use the words, but not the members of the CND.

    Death Penalty

    Switzerland, with support from others, pushed hard at the meeting for the Joint Ministerial Statement to clearly state the death penalty was not an appropriate response to drug offenses of any kind. In the end they failed, being blocked by countries like Iran, China and a number of other Middle Eastern and Asian countries. Canada’s silence on this discussion was deafening.

    The Swiss allowed the “consensus” document to go forward but not without delivering the following statement at the end of the meeting:

    “The death penalty is in opposition to our position with regard to all offences. The International Covenant on Civil and Political Rights says that it should only be applied for very serious crimes and therefore very rarely. The human rights committee says we should very much limit the use of the death penalty. The International Narcotics Control Board (INCB) said that its application was never in the spirit of the (drug) conventions. The INCB encourages countries to consider its abolition. In this background, the silence of the Joint Ministerial Statement (JMS) on the death penalty is regrettable. It does not take into account our position and that of other (UN) bodies. We will continue to promote the abolition of the death penalty. We ask that our agreement with the JMS is on this understanding – capital punishment is not in line with our commitment to combat the world drug problem. International cooperation on drug law enforcement is contingent to respect for all human rights – as well as the right to life.”

    2016 UN General Assembly Special Session on Drugs (UNGASS)

    If there’s one thing that we learned while attending the CND it’s that any meaningful consensus on new approaches to addressing drug problems globally will be near impossible to attain when the biggest international drug policy meeting in 20 years – UNGASS 2016 – takes place in two years at the UN General Assembly in New York.

    This meeting was called in response to the pleas from the presidents of Mexico, Colombia and Guatemala a little over a year ago, calling on the UN to facilitate real dialogue on alternative approaches to the global drug problems.

    UNGASS is huge because it will undoubtedly precipitate a new approach to drug policy – either through the development of a more progressive global consensus, or, more likely, because it will shatter the distorted idea that a global consensus is possible.

    Either way, countries should be free to chart their own appropriate path forward to address drug problems, grounded in the public health and human rights imperatives enshrined in various UN conventions, without the shackles of the misguided and restrictive drug control treaties.

    “Ring the bells that still can ring
    Forget your perfect offering
    There is a crack in everything
    That’s how the light gets in.”
    – Leonard Cohen, Anthem

  • Treat drug use as a public health issue, not criminal issue, say UN agencies

    Treat drug use as a public health issue, not criminal issue, say UN agencies

    Criminal activity and drug trafficking. Distressingly, those are dominant discussion points at this week’s annual UN drug policy conference – the Commission on Narcotic Drugs (CND).

    As a result, public health considerations have been somewhat sidelined, but not, thankfully, among UN agencies, where a number of key representatives called for the removal of criminal sanctions associated with drug use, and the realignment of drug use as a public health issue.

    Back in Canada, the federal government is considering changing Canada’s marijuana laws to allow ticketing by police instead of arrest, but Justice Minister Peter MacKay has insisted that even if that’s the case, “Criminal Code offences would still be available to police…. It’s not decriminalization. It’s not legalization.” What’s more, the move could be a step backwards if police begin issuing tickets, where in the past they might have turned a blind eye.

    Regardless, under the current regime, simple cannabis possession charges in Canada numbered 61,406, a rate of 178 per 100,000 people as recently as 2011. This represented a 16% increase of such incidents since 2001. In BC alone, the arrest and prosecution of personal marijuana use costs taxpayers $10.5 million a year.

    Contrast that criminalization framework with comments from UN agencies this week at the CND:

    • UN Deputy Secretary Jan Eliasson tried to set a positive tone early by emphasizing the “public health imperative” in addressing drug use, and called for a “comprehensive and open-minded exchange” that included civil society input and that didn’t shy away from “discussing innovative ideas and perspectives.” He concluded by stressing that it is not enough to say no to drugs, “we are also saying yes… to human rights.”
    • Gilberto Gerra, Chief of Drug Prevention and Health Branch for the UN’s drug control agency (UNODC) insisted that criminal sanctions are ineffective and counter-productive because they do nothing to address problematic drug use. He argued that drug policies should be based on health and not on punishment, and that nowhere do international drug conventions require that personal use should be criminalized.
    •  Two Scientific Working groups convened by the UNODC to advise the CND criticized criminal sanctions and implored delegates to base their policy decisions on science.The first – headed by Nora Volkow (Director of the United States National Institute on Drug Abuse) – insisted that “substance use disorders should be treated as medical and public health issue rather than a criminal justice and/or moral issue.” Imprisonment does not equate with treatment, and the group discouraged the use of “criminal sanctions” given that they “are not beneficial in addressing substance use disorders.”
      The second group – headed by Michel Kazatchkine (UN Secretary General’s Special Envoy on HIV/AIDS for Eastern Europe and Central Asia) – concluded that “we need to stop incarceration of people who use drugs for minor drug related offenses.” Its members highlighted the legal and regulatory impediments to implementing harm reduction initiatives and noted that the “criminalization of drug use, restrictive drug policies and aggressive law enforcement practices are key drivers of HIV and hepatitis C epidemics among people who inject drugs.” Basically, people are dying because they are treated as criminals rather than patients.
    • UNAIDS director Michel Sidibe echoed calls to understand drug use as a public health and human rights issue, stating: “The criminalization of millions of people for minor drug offences exacerbates vulnerability to HIV infection, and does little to protect society from the health and social harms caused by drug dependence.” He added, “We must work towards transforming laws and law enforcement officials to become bridges to connect people who use drugs to life saving health services.”
    • The UN High Commissioner for Human Rights Navi Pillay’s statement drew attention to “the intense focus of law enforcement against drug use” which “has resulted in large numbers of persons being arrested and held in prolonged periods of pre-trial detention for minor drug offences.” She condemned the “so-called ‘treatment’ in such centres” which “is frequently not based on individualized assessment and evidence-based medical practice, but rather in mass treatment with a focus on disciplinary-type interventions.”

    These comments represent a striking scientific consensus on the harm created by the criminalization of drugs and those who use them. Clearly the language of public health is beginning to inform the deliberations at this forum. The real challenge for countries to put teeth into these recommendations by implementing concrete and comprehensive public health approaches to drug related harm.

  • Quel rôle jouera le Canada dans l’orientation d’une politique mondiale sur les drogues?

    Quel rôle jouera le Canada dans l’orientation d’une politique mondiale sur les drogues?

    (Les liens aux sites externes sont disponibles en anglais seulement.)

    Les Canadiens s’enorgueillissent de recevoir un accueil favorable à-travers le monde. Non seulement parce que nous avons des paysages majestueux ou de braves athlètes olympiques, mais également pour nos contributions en matière de diplomatie internationale.

    La Commission annuelle des stupéfiants (CS) de l’Organisation des Nations Unies qui se réunira à Vienne les 13 et 14 mars 2014 nous offre la possibilité d’ajouter une page à cette riche histoire. À cette occasion, la communauté internationale se réunira pour discuter de la façon d’améliorer la réponse mondiale face aux problèmes liés à la consommation et au trafic de stupéfiants.

    Historiquement, le Canada a joué un rôle important dans ces débats et a prôné un large éventail d’approches en matière de santé publique, ainsi que des mesures coercitives fondées sur des données factuelles contre les groupes criminels organisés qui produisent et vendent les drogues illicites. Notre influence est décuplée par le fait que nous contribuons financièrement, de manière significative, au Programme des Nations Unies pour le contrôle international des drogues.

    Mais certains observateurs internationaux s’inquiètent de ce que nous communiquerons cette année à la Commission des stupéfiants.

    Dans un article publié récemment par l’Ottawa Citizen, Michel Kazatchkine, envoyé spécial du Secrétaire général des Nations Unies pour le sida en Europe de l’est et en Asie centrale, a fait remarquer: « Le Canada est depuis longtemps un chef de file mondial dans la mise en oeuvre de politiques de réduction des méfaits en matière de consommation de médicaments à usage domiciliaire. Voilà pourquoi il est presque choquant de voir ce pays s’aligner sur des pays tels que la Russie et la Chine, qui s’opposent à ce que la «réduction des méfaits» fasse partie des nouveaux principes élaborés par les Nations Unies pour guider les négociations lors de la session extraordinaire de 2016. »

    Kazatchkine a ensuite décrit la hausse alarmante de nouveaux cas d’infections par le VIH en Russie, attribuable au manque de services de réduction des méfaits disponibles aux usagers de drogues injectables. En fait, le gouvernement russe s’oppose généralement aux services tels que l’échange de seringues et les programmes de traitement à la méthadone, qui sont des services éprouvés permettant de sauver des vies.

    En tant qu’ancien Directeur exécutif du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme, et membre de la Commission  mondiale des politiques sur les drogues, Kazatchkine sait de quoi il parle. En effet, la Commission mondiale a sonné l’alarme en 2012 sur la relation continue entre les politiques répressives de contrôle des drogues et la propagation du VIH. Le message à retenir est donc simple : le refus d’offrir des services de réduction des méfaits aux consommateurs de drogues, jumelé à la criminalisation de la possession de drogues, oblige les individus à chercher refuge aux endroits où la propagation du VIH est beaucoup plus probable, en raison de l’utilisation commune de matériel d’injection de drogues.

    Kazatchkine n’est pas le seul expert international à exprimer ses inquiétudes face à la position du Canada. Selon un article publié dans le Journal de l’Association médicale canadienne, au cours d’une récente session de négociation menant à la CS, le « Canada se trouve encore une fois aux premiers rangs de la bataille » contre l’appui de l’ONU envers « des mesures d’atténuation et de réduction des méfaits », selon les dires du Consortium International des Politiques liées à la Drogue (IDPC), un groupe britannique témoin aux négociations. Dans unrapport publié après la session, un observateur de l’IDPC a déclaré que le Canada « s’est exprimé haut et fort tout au long » de la session et s’est opposé à toute référence au terme « réduction des méfaits ».

    Nous ne savons pas exactement quelle sera l’approche de la délégation du Canada au CS cette année, mais nous avons élaboré certaines recommandations, conjointement avec le Réseau juridique canadien VIH/sida.

    Vous pouvez lire l’ensemble de notre proposition ici.

    Nous y invitons la délégation à mettre l’accent sur les éléments suivants, lors de leurs discussions avec les autres États membres :

    1. Encourager tous les pays à adopter une démarche globale en matière de santé publique envers la consommation de drogues, y compris la décriminalisation.

    2. Encourager les pays à mettre à l’essai de nouvelles idées et politiques sur les drogues axées sur la santé.

    3. Respecter, protéger et promouvoir les droits de la personne (plus particulièrement en ce qui concerne l’opposition à la torture dans les centres de détention pour toxicomanes et l’opposition à la peine capitale pour les crimes liés à la drogue).

    4. Assurer le plein accès aux médicaments essentiels.

    5. Promouvoir le plein engagement de la société civile aux débats concernant la politique à adopter en matière de drogues.

    6. Remettre en cause l’utilité des termes associés aux efforts mis en oeuvre d’un « monde sans drogues »

    7. Reconnaître le mandat confié à l’OMS dans le cadre des Conventions de 1961 et de 1971, de formuler des recommandations en matière de classement des substances.

    Même si nos recommandations ne sont pas adoptées au cours de cette CS, nous disposons de 2 ans pour poursuivre cette conversation, avant la Session extraordinaire de l’Assemblée générale des Nations Unies (UNGASS) en 2016. Cette assemblée est d’importance capitale en matière de politique internationale  sur les drogues, et présente une occasion unique de démontrer les dysfonctionnements du présent système de contrôle des drogues. Elle représente une excellente occasion de réorienter l’approche mondiale en faveur de mesures globales de santé publique, pour faire face aux problèmes liés aux drogues.

    Le Canada est bien placé pour jouer un rôle de premier plan pour mettre de l’avant ce changement. La collectivité internationale n’attend rien de moins.

  • Measuring lives saved: the facts about safer consumption services

    Measuring lives saved: the facts about safer consumption services

    This post first appeared in the Centre for Addictions Research of BC’s blog Matters of Substance.

    Despite the pragmatic nature of harm reduction programs, and their demonstrated ability to save lives, controversy still dogs efforts to scale-up harm reduction. One of the most misunderstood and controversial initiatives are safer consumption services (SCS).

    In the last 20 years, SCS services (sometimes also known as safer injection services (SIS) have been integrated into drug treatment and harm reduction programs in Western Europe, Australia, and Canada. The focus of these services is facilitating people to safely consume pre-obtained drugs with sterile equipment. These services can be offered using a number of models including under the supervision of health professionals or as autonomous services operated by groups of people who use drugs.

    The objectives of SCS include preventing the transmission of blood-borne infections such as HIV and hepatitis C; improving access to health care services for the most marginalized groups of people who use drugs; improving basic health and well-being; contributing to the safety and quality of communities; and reducing the impact of open drug scenes on communities.

    Safer consumption services grew out of the recognition that low-threshold, easily accessible programs to reduce the incidence of blood-borne pathogens were effective and cost-effective. This was the conclusion of over 30 research studies on Vancouver’s own supervised injection site known as Insite.

    Research has found that SIS services:

    • are actively used by people who inject drugs including people at higher risk of harm;
    • reduce overdose deaths — no deaths have occurred at Insite since its inception;
    • reduce behaviours such as the use of shared needles which can lead to HIV and Hep C infection;
    • reduce other unsafe injection practices and encourage the use of sterile swabs, water and safe needle disposal. Users of these services are more likely to report changes to their injecting practices such as less rushed injecting;
    • increase the use of detox and other treatment services. For example, the opening of Insite in Vancouver was associated with a 30% increase in the use of detoxification services and in Sydney, Australia, more than 9500 referrals to health and social services have been made since the service opened, half of which were for addiction treatment;
    • are cost-effective. Insite prevents 35 new cases of HIV and 3 deaths a year providing a societal benefit of approximately $6 million per year. Research estimates that in Sydney, Australia, only 0.8 of a life per year would need to be saved for the service to be cost-neutral;
    • reduce public drug use; and reduce the amount of publically discarded injection equipment; and
    • do not cause an increase in crime.

    Professional groups such as the Canadian Medical Association, the Canadian Nurses Association, the Public Health Physicians of Canada, the Registered Nurses Association of Ontario, and the Urban Public Health Network have expressed their support for SCS.

    Clearly it’s time to move beyond controversy and get on with creating more of these life-saving programs.

  • Le décompte des 10 meilleurs moments de 2013 en matière de politiques sur les drogues

    Le décompte des 10 meilleurs moments de 2013 en matière de politiques sur les drogues

    Quelle année incroyable. Les litiges, les règlementations juridiques, les dates anniversaires, les confessions, les personnes en haut lieu qui discutent de leur consommation de drogue et de leadership politique, ont fait les manchettes. Nous avons publié le rapport qui est la pierre angulaire de notre démarche ; Se rendre au lendemain. Et de façon globale, il y a du changement au niveau des politiques sur les drogues. Il est facile de voir que l’ancien régime international, qui a rendu taboue toute discussion portant sur les alternatives à la guerre contre les drogues depuis plus de quarante ans, s’effrite. Les pays se penchent désormais sur des approches moins punitives envers les toxicomanes et se concentrent sur les acteurs violents dans nos communautés. Une meilleure politique sur les drogues est possible et nous travaillons à la bâtir, mais nous avons besoin de votre aide.

    donate1Songez à faire un don pour soutenir le travail de la Coalition canadienne des politiques sur les drogues. L’un de nos généreux donateurs a accepté de doubler tous les dons faits jusqu’au 31 décembre. Nous vous prions donc de passer à l’action dès maintenant et de
    cliquer ici pour faire un don.


    Nous vous souhaitons à tous un joyeux temps des Fêtes, et vous adressons nos meilleurs vœux de bonheur et de prospérité pour la nouvelle année.

    Allons-y ! Voici le décompte des 10 meilleurs moments de 2013 en matière de politiques sur les drogues

    10. L’organisation des États Américains (OEA) entame la discussion continentale sur les approches alternatives au problème de la drogue aux Amériques

    banner[Les Amériques] En mai, l’OEA a publié deux rapports sur le problème de la drogue aux Amériques. Inspirés par le débat passionné sur les politiques sur les drogues du Sommet des Amériques en 2012, ces rapports traitent de l’étendue du problème de la drogue sur le continent. Les rapports proposent un ensemble de scénarios visant à réduire la violence liée au trafic de la drogue, ainsi que les méfaits causés par la toxicomanie, au cours des 15 prochaines années. Nous avons participé à la création de ces scénarios, en collaboration avec 46 autres experts en matière de politiques sur les drogues, provenant des quatre coins du continent. Nous félicitons l’OEA du leadership dont ils ont fait preuve en faisant avancer le débat sur les solutions alternatives. Ils ont officialisé les échanges qui avaient déjà lieu. Au niveau international, ils ont eu le courage de demander : Existe-t-il une meilleure façon de réduire les méfaits liés au commerce illégal des drogues sur le continent et de mieux protéger les toxicomanes contre les maladies, la dépendance et les surdoses mortelles?

    #9. Le Canada met en oeuvre des peines minimales obligatoires pour les infractions liées aux drogues, au moment même où le ministre de la Justice des États-Unis qualifie de telles pratiques et politiques de « dysfonctionnelles »

    prison[Canada] Dans son allocution devant l’Association du Barreau Américain en août dernier, le secrétaire à la Justice des États-Unis, M. Eric Holder a qualifié les peines minimales obligatoires de «draconiennes» et a demandé au Congrès de réformer ce système qui n’est pas digne de respect. “Lorsque ces lois sont appliquées sans discernement, elles vont à l’encontre de la sécurité publique. Ces lois, ainsi que certaines priorités que nous avons établies en ce qui concerne l’application de ces lois, ont un effet déstabilisateur sur les collectivités qu’elles touchent, plus particulièrement les personnes pauvres et de couleur. Lorsqu’appliquées de façon irréfléchie, de telles lois sont improductives”. Félicitations à Holder et à son équipe pour avoir pris l’initiative de mettre fin à ces absurdités. Pendant ce temps, au Canada

    8. Insite célèbre son 10ième anniversaire, 2 millions d’injections et aucun décès

    insite[Canada] En septembre, Insite, le premier site d’injection supervisée autorisé au Canada, a célébré ses 10 ans au service de la collectivité du Downtown Eastside à Vancouver. 10 ans, 2 millions de visites et aucun décès. Que dire de plus ? Bravo à la PHS Community Services Society, à la Vancouver Coastal Health Authority, à la Ville de Vancouver, au gouvernement de la Colombie Britannique, au réseau des consommateurs de drogue de la région de Vancouver (VANDU) et aux citoyens de la Colombie Britannique, pour soutenir cette solution innovatrice en matière de soins de santé, qui permet de sauver des vies. Où se trouvent donc les autres sites au Canada ?

    7. Le gouvernement fédéral canadien continue à contrecarrer les programmes de réduction des méfaits permettant de sauver des vies

    parliment[Canada] Pour des raisons qui nous échappent, il est clair que le gouvernement fédéral fait tout en son pouvoir pour empêcher l’expansion de services qui permettent de sauver des vies. Le Projet de loi C -65 (rebaptisé Projet C-2), le soit-disant Projet de Loi sur le respect des collectivités, énonce 26 exigences supplémentaires auxquelles le prochain site d’injection supervisée devra répondre avant de recevoir l’approbation du Ministre fédéral de la santé. Le Projet de loi C-2 est une autre mesure visant à entraver l’expansion des services permettant de sauver les vies et d’améliorer le destin des toxicomanes. Compte tenu de la montagne de recherches revues par des pairs démontrant l’effet positif des sites d’injection, et de la décision unanime de la Cour Suprême du Canada en faveur d’Insite, nous sommes en droit de nous demander quel est l’objectif réel du gouvernement fédéral ? Nous continuerons à militer en faveur de l’expansion de tels programmes au Canada.

    6. Les ONG canadiennes intentent des poursuites contre le gouvernement fédéral en raison de l’absence de programmes d’échange de seringues en milieu carcéral

    syringe[Canada] Le 25 septembre 2012, l’ancien détenu fédéral Steve Simons, le Réseau juridique canadien VIH/sida, le Réseau d’action et de soutien des prisonniers et prisonnières vivant avec le sida, le Réseau canadien autochtone du sida et le Réseau canadien d’info-traitements sida ont engagé une action en justice auprès de la Cour Supérieure de l’Ontario, alléguant que le gouvernement fédéral viole les droits des prisonniers en vertu de la Charte canadienne des droits et libertés, en omettant d’assurer l’accès à des seringues stériles en prison. Conséquemment, les taux d’infection au VIH et au VHC sont respectivement 15 et 39 fois plus élevés dans les prisons canadiennes que dans d’ensemble de la population. Pour obtenir plus d’informations sur cette affaire, consultez le site www.prisonhealthnow.ca et pour en savoir plus au sujet du prochain forum spécial ouvert au public à ce sujet, voir :www.facebook.com/events/233425186819563/?previousaction=join&source=1

    5. Les états de Washington du Colorado mettent en oeuvre des systèmes de réglementation permettant la production et la vente de cannabis aux adultes

    canabbis[Etats-Unis] En octobre dernier, la Régie des alcools de l’État de Washington a adopté des règles permettant la mise en oeuvre d’un marché réglementé du cannabis pour les consommateurs adultes. Ces règles servent de base au marché de la consommation de cannabis par les adultes, récemment mis en place dans l’État de Washington, et sont le fruit de 10 mois de recherche et de participation publique. Les électeurs de l’état ont voté en faveur de la légalisation du cannabis en novembre 2012. Au moment de l’impression, le Colorado met également en application son propre système réglementaire.

    4. Providence Health Care et la PIVOT Legal Society intentent des poursuites à l’encontre du gouvernement fédéral, en ce qui concerne les droits d’accès particuliers à la diacétylmorphine.

    salome[Canada] –  Developing policy through the courts is not advised but there comes a time when it is the only way to get things done. On November 13th Providence Health Care, PIVOT Legal Society and five patients in the SALOME clinical trial launched a constitutional challenge in the wake of the federal government’s decision to prohibit the pres[Canada] Il est déconseillé d’élaborer des politiques par voie judiciaire, mail il arrive parfois que ce soit le seul moyen d’accomplir quelque chose. Le 13 novembre dernier, Providence Health Care, la PIVOT Legal Society et cinq patients prenant part à l’essai clinique SALOME, ont intenté une contestation constitutionnelle suite à la décision du gouvernement fédéral d’interdire la prescription de la diacétylmorphine (héroïne) aux personnes souffrant de dépendances chroniques. La Présidente de Providence Health Care, Mme. Dianne Doyle , a annoncé la poursuite en justice, dans le but de renverser la décision prise par la ministre fédérale de la santé, Mme. Rona Ambrose, interdisant aux médecins de prescrire de l’héroïne aux patients souffrant de dépendance grave à l’héroïne, dans le cadre de leur traitement. Le « traitement à la diacétylmorphine, ou le traitement de prescription médicale d’héroïne, est une solution de traitement éprouvée, » déclare Doyle. Pourquoi le Canada n’accorde-t-il pas une plus grande priorité au traitement de la toxicomanie ?

    3. L’Uruguay passe à l’histoire en devenant le premier pays au monde à légaliser la production, la vente et l’utilisation du cannabis par les consommateurs adultes

    Uruguay[Uruguay] Le gagnant du prix 2013 du leadership en matière de politiques sur les drogues est clair. Le Président de l’Uruguay, M. Jos Mujica, remporte haut la main pour la persistance dont il a fait preuve, malgré une forte opposition à la mise en place de mesures législatives avant-gardistes créant le premier marché réglementé national du cannabis au niveau mondial, marché qui sera sous contrôle public. Le 10 décembre, le Sénat uruguayan a adopté un projet de loi mettant en oeuvre un cadre règlementaire pour le cannabis. Lorsqu’on lui a demandé comment il savait avec autant de clarté qu’une telle approche devait être adoptée, Mujica a répondu : « L’approche traditionnelle n’a pas fonctionné. Il fallait bien qu’un pays soit le premier à adopter cette solution. »

    2. Sensible BC propose un amendement novateur à la Loi sur la police de la Colombie Britannique, en faveur du relâchement de l’application de la loi en matière de possession de petites quantités de marijuana

    sensible[Canada] Toutes nos félicitations à Sensible BC pour leur campagne novatrice et créative visant à réduire les méfaits causés par la criminalisation de la possession de cannabis cette année. La partie n’est pas encore gagnée, mais vous vous êtes bien fait comprendre et avez tracé les prochaines étapes du parcours vers le changement inévitable des politiques sur le cannabis au Canada. Le 9 décembre 2013 marque le dernier jour de la campagne de 90 jours de Sensible BC, qui a permis de recueillir 200 000 signatures d’électeurs de la Colombie Britannique. Ces électeurs étaient en faveur de la décriminalisation et de la réglementation de la marijuana. Cette mesure législative intitulée Sensible Policing Act est un amendement la Loi sur la police de la Colombie Britannique, qui décourage l’utilisation de toute ressource policière, y compris les heures de travail des officiers de police, pour fins d’investigation, de dépistage, de saisie, de citation, d’arrestation ou de détention liés à la possession simple de cannabis. Essentiellement, si cette mesure est adoptée, elle permettrait de décriminaliser la possession de cannabis en Colombie Britannique, sans avoir à modifier la loi fédérale. À la fin de la campagne, plus de 4 500 bénévolesrecueillaient des signatures, d’un bout à l’autre de la province. Nous les remercions tous de travailler à la mise sur pied de meilleures politiques sur les drogues en Colombie Britannique et au Canada.

    et roulement de tambour…. …. …. Le numéro 1 au palmarès des politiques sur les drogues en 2013

    1. Les canadiens discutent ouvertement de la toxicomanie

    [Canada] Il semble que durant toute l’année, les canadiens on discuté ouvertement de la question de la consommation de drogues, grâce à des hommes politiques tels que le chef libéral Justin Trudeau, ainsi que Rob Ford, le maire de Toronto. Voilà donc, à notre avis, le moment le plus important de l’année en matière de politiques sur les drogues. Justin reconnaît avoir récemment fumé du cannabis, même en sa qualité de député siégeant. Rob Ford – Bon, sans trop entrer dans les détails, il a reconnu avoir fumé, « beaucoup de cannabis » et consommé du crack de cocaïne. Les canadiens en ont rajouté. Ils ont fait des reproches, couvert de honte, fait preuve de compassion, argumenté, dénigré, réfléchi à leurs propres problèmes de consommation de drogues, ont rassemblé des experts en matière de dépendance sur les émissions d’entretiens télévisés, et ont généralement démontré toute la gamme de réactions que les toxicomanes éprouvent à tous les jours, du meilleur au plus mauvais.

    C’est un moment historique pour le Canada. Notre problème en matière de politiques sur les drogues est désormais évident. En janvier, avant que toutes les résolutions du Nouvel An ne deviennent des sujets de second plan, joignez-vous à nous et à nos partenaires d’un bout à l’autre du pays, pour accélérer le débat sur l’avenir des drogues et des politiques sur les drogues au pays. Demeurez à l’affût de toutes les occasions de vous impliquer qui s’offriront à vous.

    Aidez-nous s’il vous plaît à poursuivre notre travail en faisant un don unique ou un don mensuel à la CCPD. donate1

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  • World Aids Day 2013: If our goal is zero, drug policy reform is crucial

    World Aids Day 2013: If our goal is zero, drug policy reform is crucial

    Zero New HIV Infections. Zero Discrimination and Zero AIDS-related deaths. That is the goal set by UNAIDS over the next two years. But when it comes to stopping HIV transmission associated injection drug use, we have a long way to go.

    “An effective AIDS response among people who inject drugs is undermined by punitive policy frameworks and law enforcement practices” (UNAIDS 2013)

    The 2013 UNAIDS Global report notes that HIV prevalence among people who inject drugs ranged from 5% in Eastern Europe to 28% in Asia.  Rates of HIV among drug injectors in Canadian cities range from approximately 5% to more than 30%. According to Canada’s own Public Health Agency, more than 50% of new HIV infections among Aboriginal people in Canada were caused by intravenous drug use. Rates of HIV and hepatitis C among people incarcerated behind the walls of Canada’s prisons are 10 to 30 times outside those same walls. Although Corrections Canada claims that injection drug use is strictly prohibited within its facilities, no prison system in the world is able to keep drug use out.  But only two of 32 reporting countries surveyed by UNAIDS provided adequate access to sterile syringes for persons who injects drugs in prison.

    In 2012 the Global Commission on Drug Policy released a groundbreaking report titled “The War on Drugs and HIV/AIDS: How the Criminalization of Drugs Fuels THE Global Pandemic.” The report points to the inability of law enforcement to reduce global drug supply and raises the alarm about the role that repressive drug control policies play in driving the HIV epidemic in many regions of the world. The report also details how policies that prohibit needle distribution result in increased syringe sharing.  In fact the Global Commission confirms what others have been saying: the fear of arrest drives people underground and away from needed services. Together these repressive policies help to escalate HIV infections. The Commission urges countries to make available proven drug treatment and harm reduction services, to reduce HIV infection and protect community health and safety.

    It’s clear that ending prohibition and scaling up harm reduction is an integral part of solving the complex global HIV problem. By drawing on the evidence of what works, British Columbia has made significant strides at reducing infection rates, but our federal government willingly refuses to acknowledge the role that harm reduction plays in protecting everyone’s health.

    On September 30, 2013, the second anniversary of the Supreme Court of Canada decision that instructed the Canadian government to issue a permit for the supervised injection site, Insite in Vancouver, we worked with the Canadian HIV/AIDS Legal Network and PIVOT Legal Society to register our concerns to Health Minister Ambrose about attempts by the federal government to block the implementation of life-saving health services for people with addictions, in the face of extensive scientific evidence of their benefits in protecting public health and public safety. Our letter  to Ambrose, which garnered the support of more than 50 organizations in Canada, challenged her government to get going on life-saving harm reduction services. We are still waiting for a response.

    Along with our commitment to World Aids Day, we will also continue to mark September 30 (9-30), the anniversary of the Supreme Court decision supporting Insite. We invite you to join us and help ensure that supervised consumption services become a part of the continuum of care for people who use drugs in Canada. And finally, please consider contributing to help our small but mighty team continue to work for evidence based and human rights focused drug policy reform in Canada.