Transatlantic Conference Brussels, November 12, 2013 “Time to Rethink our Policy on Drugs -
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Transcript of Transatlantic Conference Brussels, November 12, 2013 “Time to Rethink our Policy on Drugs -
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Transatlantic Conference
Brussels, November 12, 2013
“Time to Rethink our Policy on Drugs -Experiences from Europe and the
Americas”
Pavel Bem, MD.
National Drug Commission, Czech Republic
Global Commission on Drug Policy
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„Opportunities and risks stay so close together…“
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50 Years of World’s Experience of Combating
Illicit Drugs International cooperation in supply
reduction Crop eradication Policies based on balanced approach
between repression and prevention Role of primary prevention/health
education Treatment and rehabilitation Focus at urban policies
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50 years of wishful thinking
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Negative Results:Supply reduction failed
Supply of illicit opioids has increased 400% in last 30 years
75% decrease of heroin black market price
900% increase in heroin purity US budget increase in war on drugs:
600% (United Nations Office on Drug and Crime, 2010)
No effect on supply reduction side
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Negative Results:”Balanced” drug policies
failed Drug policy “driven” HIV epidemics, mortality
Policy “driven” HCV epidemics, morbidity Missing balance in total expenditures:
“supply vs. demand” 80% vs. 20%
Failure in assessment of evidence based approach
20% vs. 80% Failure of national as well as supranational
organizations in effective response
Unintended negative consequences
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Mustang: Ghar, Ghiling Gompa, 9-10th cent.
“Unintended negative consequences”:
Overall cost is to high…
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We act only on the “surface” of the problem…
BUT…
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Positive Results: Demand and harm reduction
works Reducing HIV prevalence among PDU’s Reducing HCV prevalence among PDU’s Reducing hidden population of PDU’s Reducing mortality among PDU’s Reducing morbidity among PDU’s Reducing not only public health risks,
but overall social and economic costs
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The need for paradigm change Acceptance of failures
Understanding of best practices
The role of supranational authorities:
Active leadership (Latin America + Europe…)
l
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The need for paradigm change
Prague: case study
Czech experience
Global Commission on
Drug Policy
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Prague Drug Policy Design
Pragmatic approach Realistic attitude Data based design Balanced policy and
measurable outcomes
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Prague Drug Policy Design
Balance between public health and safety
Economy driven drug policy Evidence based interventions Police does it’s job on drug supply side Demand and harm reduction services Measurable outcomes (HIV, HCV,
morbidity)
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Prague Drug Policy Design
Availability of needles and syringes
Availability of services + outreach
Methadone + Buprenorphine + … Non-punitive legal framework
(possession is not legal offence)
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HIV prevalence among IUDs in Europe
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Drug Overdoses–EU Countries
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16.11.2011 Seite 11This Project is funded by the European Union and implemented by a EU MS Consortium
Prevalence of PDUs in Europe Estimates of the prevalence of problem drug use (cases per 1 000 population
aged 15–64 (cases per 1 000 population aged 15–64)
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Where are the benefits?
Low proportion of hidden population (< 30%) Low mortality rate Low prevalence of HIV among PDU’s-IVDU Manageable morbidity rates Manageable dynamics Reduced public health risks Acceptable economic and social costs
14
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BUT…
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We behave in simplistic way with no respect to human diversity and human rights (Papua, 2003)
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New Penal Code: 1998
Penalizing possession
Czech Republic case study
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PAD: Impact Analysis Project of the New Drug
LegislationComplex Cost and Benefit Analysis (5 major studies and 20 sub studies):
1. Secondary analysis of school surveys
2. Prevalence study of problem drug use in the CR
3. Economic and social cost of illegal drug use in the CR
4. Qualitative study among illicit drug users
5. Cost and benefit analysis of the implementation of
penalization of possession of illicit drugs for
personal use
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Research Methodology
Combination of quantitative and qualitative methods
Measuring the direct as well as indirect costs
Interdisciplinary research team Supervised by Florida State
University, School of Criminal Justice
Granted by the National Drug Commission
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Main Hypothesis
1. Availability of Illicit Drugs Will Decrease 2. Use of Illicit Drugs Will Decrease 3. Incidence of Illicit Drug Use Will
Decrease 4. Negative Health Indicators Will Not Increase 5. Social Costs Related to Drug Abuse Will
Not Increase After Introduction of a Penalty of Possession for Personal Use
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Results
All hypothesis were rejected in 3 years study
No positive impact of the criminalization law at all
Lead to Decriminalization Act 2008
Evidence based additional costs for public budgets
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Recommendations Prague Declaration, 2009
1.No size fits all2.Realism is the key3.Human rights apply to ill
people in particular4.Public health and public
safety concerns must not be seen as contradictory5.Evidence based decision only6.Evaluation and monitoring7.Constant and improving mutual
information flow
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Drug Policies at Crossroad
Conclusions:
1. War on drugs has failed:Need for “rebalancing action” in drug policies design
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Drug Policies at CrossroadConclusions:
2. Need for wider implementation of cost effective public health measures:Harm reduction services especially at areas of high risk
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Drug Policies at CrossroadConclusions:
3. Decriminalization of drug possession and drug consumption worldwide
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Drug Policies at Crossroad
Conclusions:
4. Reallocation of drug budget priorities
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The need for paradigm change Growing awareness internationally (Global Commission on Drug Policy: former presidents,
prime ministers, UN officials, intellectuals…)
Vienna high level meeting: CND 2014
(EU Action Plan on Drugs 2013-2016, action #5]
UNGASS 2016
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“Wishful thinking” is still prevailing among many politicians, decision makers as well as media
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www.globalcommissionondrugs.orgwww.vlada.cz
www.cadap.eu www.praguedeclaration.com
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Thank you for your attention