DRUG USE IS a constant feature in the media. This month alone, there have been reports of students being hospitalised after consuming LSD and amphetamines, deaths linked to PMMA and problems of unsafe disposal and public drug use in Dublin city centre. Such stories are recurring; it’s clear that our current policy approach to drugs is not having the intended effect – but there are alternatives.
A good starting point is to consider what is currently being done from a policy perspective. Like most countries, Ireland’s drug policy is guided by the three international conventions on narcotics which have set the global policy agenda since the 1960s. Ireland is a signatory to these treaties, and we are bound by them. The conventions create the basic framework within which signatories must work, and they establish a generally restrictive policy approach.
Naturally, this has resulted in signatory states implementing a regime which is largely focused on controlling drug trade and use through criminal sanctions. These international conventions are the framework on which the ‘War on Drugs’ is based. They are also often cited as a barrier to reform of drug policy at the level of individual countries, not least because the International Narcotics Control Board (INCB), which was set up to monitor parties’ compliance, is conservative in its approach (as recently as 2012, the INCB characterised opioid substitution programmes as a form of continuing drug abuse, despite decades of evidence supporting their use as an essential treatment component).
However, many commentators note that the conventions are not entirely restrictive. For example, the focus is primarily on trafficking, and a number of articles require the provision of support to drug users. It has been argued that these articles allow sufficient leeway for the implementation focus to be on health, instead of criminal justice outcomes. As the Runciman Report noted as far back as 2000:
It is in the area of drug use, possession and related acts that the scope left by the international conventions for different approaches is widest. We have found that it is not well understood that for such offences there is express provision for imposing measures such as treatment, education, rehabilitation or social reintegration. These measures may be imposed either in addition or, more importantly, as an alternative to conviction or punishment.
If this is the true state of play, there is more scope under the conventions than we might think. However, the debate on drug policy can often be polarised, with both zero tolerance and legalisation put forward forcefully by their various proponents. Of course, polarisation is rarely helpful, as people tend to focus on what distinguishes their views from those of the other side, rather than looking to find common ground.
However, we can find some common ground by looking at the objective evidence. The London School of Economics recently published a report on the ‘War on Drugs’ and made a few significant points. First, that supply and demand for illicit drugs is not something to eradicate, but to manage; second, such supply and demand is currently being managed badly; and third, that the focus of drug policy should be on public health, not on criminal justice. The investor and philanthropist George Soros agrees, and has weighed in with an opinion piece in the Financial Times, noting that:
The war on drugs has been a $1tn failure. For more than four decades, governments around the world have pumped huge sums of money into ineffective and repressive anti-drug efforts. These have come at the expense of programmes that actually work such as needle exchanges and substitution therapy. This is not just a waste of money, it is counterproductive.
Given that this is the case, what should we be doing to address the issues we see reported in the Irish media? There is a clear need to greatly expand some of the measures we already have in place. For example, we should ensure that sufficient needle and syringe programme (NSP) coverage and residential treatment beds are provided to cater to the amount and profile of people who use drugs in Ireland.
There is also a need to look at what other evidence-based policies might work. On-the-spot drug testing is a possible intervention for people at risk of deaths and hospitalisation from ‘club’ drug use. Research is currently taking place in the UK to test the drugs people are using at the Warehouse club in Manchester, enabling real time warnings to be issued when unexpected substances are found.
Medically supervised injection centres (MSICs), are an option to address the issue of public injecting and unsafe disposal. These are a form of drug consumption room (DCR) where people can inject illicitly obtained drugs in a safe environment. If we accept that Dublin has a concentration of problems connected with injecting drug use, including unsafe disposal, then there is compelling evidence from other jurisdictions that MSICs should be piloted and evaluated here.
There is a need to implement strongly-evidenced policy approaches to address Ireland’s particular set of circumstances. In terms of service delivery in Ireland, this will mean diverting funds from those policy responses that are largely ineffective to public health policies that are effective.
And what of the argument that we are hamstrung by our convention obligations, that to implement progressive policy is not compliant with the provisions of the international system to which Ireland subscribes? Well, in reality compliance with the international conventions has not been a barrier for other jurisdictions when implementing progressive national drug policies. For example, the truth is that implementing an MSIC is highly unlikely to attract the wrath of the international community.
There are 87 drug consumption rooms in operation around the world, in eight countries (including 26 in Germany). While all of the countries who have implemented these measures are bound by the international conventions, none has suffered any consequences as a result of their policy, other than purported non-compliance with the conventions being noted by the INCB.
If we want to reform the system and pursue progressive policies in Ireland, the control is truly in the hands of the Oireachtas, and not in those of the UN. Furthermore, the recent London School of Economics report has now placed finance at the heart of any debate about drug policy, concluding that the global war on drugs has:
…failed based on its own terms. Evidence shows that drug prices have been declining while purity has been increasing. This has been despite drastic increases in global enforcement spending. Continuing to spend vast resources on punitive enforcement-led policies, generally at the expense of proven public health policies, can no longer be justified.
The war on drugs has failed and we should try alternative approaches. In fact, not to change the way we think and how we spend our money on drug policy is to simply waste money. In straitened times, drug policy is not just a debate about health, criminal justice and related issues; it is a financial imperative.
Tony Duffin is the Director of the Ana Liffey Drug Project. The Ana Liffey provides social and health services to over 3000 individuals every year, most of whom use drugs problematically. In addition to this, Ana Liffey run a number of online and digital services, including the aldp.ie and drugs.ie websites. You can contact Ana Liffey on Facebook, Twitter, and at info@aldp.ie.
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