Video 8: Prohibitionist drug policies: violations of human rights

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来自 University of Geneva 的课程

Drugs, drug use, drug policy and health

4 个评分

University of Geneva

Drugs, drug use, drug policy and health

4 个评分

This MOOC is the first of its kind, since it addresses critical issues related to drugs from a multidisciplinary, health and human rights-based approach. Throughout the course you will cover a range of questions including what are drugs and why they controlled? What are the benefits and harms of taking drugs? How public health policies can address drug use? You will also learn about the intricacies of the international drug control framework and the negative consequences of widespread prohibitionist drug policies around the world. Finally, you will examine ways of furthering drug policy reform. The topics will be presented by over 40 speakers from scientific, academic and institutional backgrounds, spokespersons of civil society as well as people who use drugs presenting their views. By the end of the course you will have: - a strong understanding of the major health issues related to drug use and drug policy; - a clear vision of why drug policy is debated today; - and, if you so wish, you will be equipped to engage in the drug policy reform movement at your local or regional level.

从本节课中

Module 4: Questioning prohibition-based policies

Welcome to Module 4 which looks at questioning prohibition-based policies. In this Module, you will discover that most drug policies in the world are based on prohibition law enforcement and criminalization of drug use ; and see that such policies have a number of negative consequences on people’s health as well as on their human rights. This Module will also look at law enforcement more closely and reveal how it can cooperate to improve health. You will learn about the human rights framework and the drug control framework and see what human rights violations, stemming from the implementation of prohibitionist drug policies, look like around the world. Finally, you will also see that drug policies are connected to development and the environment, most often not in a good way, with prohibition fueling violence, crime and corruption and impeding development. By the end of this Module you will be able to: • Evaluate the extent to which prohibition-based policies have succeeded or failed in reducing drug production, trafficking and consumption; • Describe the negative impacts of prohibition-based policies on health, human rights and development; • Recall how prohibition-based policies fuel organized crime and trafficking. We hope this week will provide you with valuable insight into the reality of prohibitionist drug policies, for people in communities all over the world ; and help you see what have been the consequences of these policies, in terms of their impact on human rights, health and development. We also hope you enjoy the essential reading and optional additional resources we have prepared for you. Best wishes,The Drugs, Drug Use, Drug Policy and Health team

Video 7: How the human rights framework and the drug control framework interact12:00

Video 8: Prohibitionist drug policies: violations of human rights9:11

Video 9: Prohibitionist drug policies: violations of human rights of women who use drugs14:06

Video 10: A closer look at drug policies in Asia – the limits of extremity in drug policy8:41

Video 11: Violations of human rights in Central America and South America6:10

Video 12: Prohibitionist law enforcement drug policies negatively impact development and the environment6:46

Video 13: Prohibition fuels violence, crime and corruption9:24

Video 14: How prohibition fuels violence, crime and corruption: the situation in Central America6:37

Video 15: How drug law enforcement affects drug markets5:55

与讲师见面

Michel Kazatchkine
Senior Fellow
Global Health Center, Graduate Institute for International Affairs and Development, Geneva
Barbara Broers
Professor (in Addiction Medicine)
Community Health Departement, Geneva University Hospitals
Aymeric Reyre
Senior Lecturer
Faculty of Medicine, Paris 13 University
Jennifer Hasselgard-Rowe
Researcher and Lecturer
Institute of Global Health, University of Geneva

[MUSIC]

So we know that one in five people in prison around the world are there for

drug-related charges.

And I think to me this suggests the scope of the problem of how

we respond to drug use in societies around the world.

We have in law a principle of proportionality, that is

the sentence should be proportionate to the offence under criminal law.

And yet when we look at the number of people in prison for drug-related

offences, and we know that the large majority of those people are there for

non-violent drug offences.

Then we have on a massive scale, a question of disproportionality in

the application of our criminal law when it comes to drugs.

And we also then have to be concerned about the implications of putting so

many people in prisons, especially so many people who are there,

in part, because of their own problematic drug use.

We know that putting people in prison for

a health condition is not likely to lead to particularly good results.

And in fact, the evidence we have suggests that it doesn't.

We know that very substantial numbers of people in prisons for

drug offenses are there with a current or a past experience of problematic use.

In some cases, their involvement in criminal activity is simply to support

their own use of substances, even when we're talking about people in prison for

trafficking offenses for example, not just possession charges.

And so we're taking a population that we know is already at risk of

experiencing poor health in various ways,

including with infectious diseases such as HIV and hepatitis C and other

bloodborne infections acquired through the use of non-sterile injecting equipment.

And we're putting people in places where their health then deteriorates further.

In many cases,

because the policies of correctional systems in fact deliberately compound

that problem by denying people access to the health services that they need.

We know over and over again that people

in prison of course experience often very poor conditions of detention generally.

But if you're someone who is experiencing withdrawal from drugs for example and

you're denied access to evidence-based treatment for

your problematic substance use, for opioid use disorder, for example.

Then we have just done a further harm to your health.

And in fact, in most prisons of the world people who have

problematic opioid use are denied access to evidence-based

treatment such as opioid substitution therapy.

At last count, only 52 countries of the world provided access to opioid

substitution therapy in prisons for people with opioid use disorder in some form.

And in many cases, that's not necessarily going to be a program,

even where it does exist, that is taken to scale and that everyone has access to it.

In my own country, for example Canada, there are numerous prison

systems where it is very difficult to get access to opioid substitution therapy,

even though this is a well established evidence-based medical intervention

outside prison and much of the country.

We also have some prisons and we are not unique in this by any means.

Where even if you may be allowed to continue your treatment with opioid

substitution therapy, if you are receiving that treatment before being imprisoned,

you are not allowed to actually start that treatment while imprisoned.

Which seems a very poor public health approach to a known problem,

a documented problem in our present system.

We have even fewer prisons in the world that actually provide access to sterile

injection equipment.

And yet we know that virtually every prison in the world at some

point people who are incarcerated there

will have access to controlled substances in some way.

Drugs make their way into our prisons,

despite all of the efforts by prison authorities using technology, and

sniffer dogs, and scanners, and searchers and so on.

We know that drugs make their way into prisons.

Prison systems themselves admit this in many cases.

What is much harder to get in prison is the means to actually use those

substances safely with as little risk as possible.

And so we also know documented in prison after prison around the world that when

people have access to drugs in prison but they don't have access sterile injection

equipment, people share injection equipment and people share injection

equipment that they make themselves out of whatever they can get access to in prison.

And we know of course that we have documented cases of outbreaks in prison of

infectious diseases including HIV and hepatitis C.

None of this should come as a surprise to us.

The people who use drugs that are being disproportionately incarcerated in our

prisons are disproportionately a population at risk of acquiring HIV and

hepatitis C outside of prisons.

To then concentrate that population in one place and

further deny them the means of preventing onward transmission

results in the very predictable consequence of further transmission.

This is a public health disaster in the making.

We also know in prison after prison around the world,

the getting access to basic health care services is often very difficul.

And for prisoners who may be living with HIV or

other serious illness, this problem can be even more significant.

In many cases,

prisoners just simply don't get access to antiretroviral treatment for their HIV.

We can't ignore these things happening in our prisons,

because the health of prisoners is actually ultimately public health.

We also know from the data that the large majority of people who go to prison,

at some point will come out of prison.

So what happens to their health while in prison, of course,

necessarily has an effect on the health of the broader community.

If people go into prison, they're being sentenced to lose their liberty as

a penalty for what they have done.

It is in no way at all justified to deny people

access to health services and in fact,

to put them at greater risk of acquiring serious infections while in prison.

There is simply no justification in the philosophy of criminal law that would

consider that a just sanction.

And yet that is precisely what we do in the case of people who use drugs and

incarceration as our principal response to them.

When people leave prison, of course, they not only leave with

whatever health conditions they may have acquired in prison,

such as infections with HIV or hepatitis C.

We also know from the data that people with problematic substance use

are at greater risk of returning to drug use, especially if they've not had

any access to effective drug dependence treatment in prison.

And they are therefore in the period after release from prison at greater risk

of experiencing an overdose, including potentially a fatal overdose.

And yet in many places not only here we're not providing access to

effective drug dependence treatment for people while they are incarcerated

even though we know they're at risk of overdose when leaving.

There isn't good transition planning, pre-release planning,

to connect people to services.

And to make sure that people have access to the information, and

to the interventions that they might need if they do return to using opioids for

example.

Such as having easy access to naloxone, the emergency antidote that can reverse

an overdose and prevent it from actually killing someone.

So there are many points at which the experience of imprisonment

as a response to drug use actually is making people's health much worse.

The notion that by putting people in prison we are somehow going to do

them good,

that we are going to act to their benefit is actually not borne out unfortunately,

in the evidence from prison system after prison system around the world.

In most cases, what happens is the prosecution and

imprisonment of people who use drugs actually makes the situation worse.

In some cases, it leads to death.

This is not a proportional response to drug use.

And it's time for our policy makers and our prison authorities to drastically

rethink why it is that we're using imprisonment as society's predominant

response to drug use, rather than actually scaling up health services that

are evidence based, and will do much more good to protect both individual health and

the health of the public more broadly.

[MUSIC]

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