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Top United Nations Health Official Calls On Countries To Replace War On Drugs With ‘Alternative Regulatory Approaches’



A United Nations expert on the right to health is urging member nations to end the war on drugs and instead enact harm-reduction policies such as decriminalization, supervised consumption sites, drug checking and widespread availability of overdose reversal drugs like naloxone—while also moving toward “alternative regulatory approaches” for currently controlled substances.

“Criminalization is but a single—and extreme—option within a regulatory system,” says a new report from Tlaleng Mofokeng, the UN’s special rapporteur on the right to health. It instead calls for regulatory frameworks around substances to be “more or less restrictive depending on scientific evidence and considering power asymmetries” and notes that “regulation models may consider whether permitting and regulating access would reduce overall harms.”

Among the UN report’s recommendations is that countries “decriminalize the use, possession, purchase and cultivation of drugs for personal use and move toward alternative regulatory approaches that put the protection of people’s health and other human rights front and centre.”

The 19-page report from Mofokeng, who is also a medical doctor and professor at Georgetown University’s Law School, urges that leaders “move from a reliance on criminal law and instead take a human rights-based, evidence-based and compassionate approach to harm reduction in relation to drug use and drug use disorders.”

“All stakeholders must respect people who use drugs, people with drug use disorders and people whose health and well-being is affected by drug laws and policies,” the special rapporteur said in a statement.

Efforts to enforce drug laws often cause more harm than good, the report contends.

“The criminalization, overuse of incarceration, arbitrary deprivation of life, unnecessary use of lethal force in drug enforcement and application of the death penalty as punishment in the name of public health have resulted in various human rights violations,” it says. “In contrast, when well designed and implemented, drug laws and policies—including in harm reduction—can protect and promote public health while contributing to the realization of human rights in a mutually reinforcing way.”

The document also includes a number of specific tools—what it calls a “non-exhaustive list of practical harm reduction measures” that member states have begun to implement, such as needle and syringe programs, medication-assisted treatment of opioid dependence and use disorders, safe injection sites, drug checking and overdose prevention and reversal.

It also says that basic needs and services, such as housing, employment and education “should not be conditional on the discontinuation or reduction of drug use, or maintained through mandated or compulsory tests.”

While the root causes of drug use and drug use disorder are multifaceted, research has shown that the deterioration of social and economic well-being is associated with increases in overdose deaths – often referred to as ‘deaths of despair,'” the UN report says. “In addition, legal services and legal training for people who use drugs can assist with access to housing, health and social services and awareness of rights and when those rights are being violated.”

But funding for harm reduction globally is “inadequate and shrinking,” Mofokeng’s assessment says: “Reportedly, only $131 million is currently available for harm reduction in low- and middle-income countries and less than 7 per cent of international donor funding for harm reduction is given to community-led harm reduction organizations. There is a 95 per cent funding gap for harm reduction in low- and middle-income countries.”

The UN special rapporteur also drew attention to the inequitable impacts of the policing of drug laws.

“The enforcement of drug laws and policies compounds other forms of discrimination and disproportionately affects certain individuals, such as persons in situations of homelessness or poverty, persons with mental health issues, sex workers, women, children, LGBTIQA+ persons, Black persons, Indigenous Peoples, migrants, persons who are incarcerated or detained, persons with disabilities, persons living with HIV, tuberculosis or hepatitis, and persons living in rural areas,” Mofokeng told the UN’s Human Rights Council. “International drug control conventions have negatively affected the availability, accessibility, acceptability and quality of certain drugs used as medicines.”

The human rights organization Amnesty International cheered the UN report for encouraging a “move away from punitive responses to drugs and to instead take an approach grounded on harm reduction and human rights,” saying it “powerfully highlights that another way is possible.”

“This is a bold and urgent call on governments worldwide to finally abandon the manifestly failed policies of the so-called ‘war on drugs,’” Erika Guevara-Rosas, Amnesty International’s senior director for research, advocacy, policy and campaigns, said in a statement. “For over six decades, this ill-conceived approach to public health has not only failed to reduce the use and supply of drugs, it has also resulted in widespread human rights violations, violence, mass incarceration, suffering and abuse across the globe, affecting disproportionately people from historically marginalized communities.”

“Many lives have been sacrificed and it’s time to stop wasting resources,” Guevara-Rosas continued. “Governments must consign the ‘war on drugs’ to history and start implementing all the recommendations outlined in this report. This includes decriminalizing personal use, possession, cultivation and acquisition of drugs and moving towards the effective regulation of drugs to ensure legal and safe access for those authorized.”

Separately, Amnesty International released a report this week calling for the legalization and regulation of all drugs. That report, titled Time for Change: Advancing New Drug Policies That Uphold Human Rights, was published to mark World Drugs Day, which is on Wednesday, the group said.

The UN report comes as international bodies and national governments across the world adjust their approaches to drug control and regulation.

Late last year, for example, 19 Latin American and Caribbean nations issued a joint statement acknowledging the need to rethink the global war on drugs and instead focus on “life, peace and development” within the region.

A report last year from an international coalition of advocacy groups, meanwhile, also found that global drug prohibition has fueled environmental destruction in some of the world’s most critical ecosystems, undermining efforts to address the climate crisis.

And a year ago, UN special rapporteurs in a separate report said that “the ‘war on drugs’ may be understood to a significant extent as a war on people.”

“Its impact has been greatest on those who live in poverty,” they said, “and it frequently overlaps with discrimination directed at marginalised groups, minorities and Indigenous Peoples.”

In 2019, the UN Chief Executives Board (CEB), which represents 31 UN agencies including the UN Office on Drugs and Crime (UNODC), adopted a position stipulating that member states should pursue science-based, health-oriented drug policies—namely decriminalization.

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Ben Adlin, a senior editor at Marijuana Moment, has been covering cannabis and other drug policy issues professionally since 2011. He was previously a senior news editor at Leafly, an associate editor at the Los Angeles Daily Journal and a Coro Fellow in Public Affairs. He lives in Washington State.


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