Crises and radical thinking on drug policy

Reform has always been a “two-steps forward, one-step back” undertaking.

It’s sad that drug policy reform must always be wrapped tragedy but alas – in the context of drugs – crisis has historically been the mother of invention.

It was in the face of thousands of overdoses and the highest HIV prevalence in Western Europe that Switzerland introduced effective heroin-prescription programmes, safe injection facilities, needle and syringe-exchange programmes and low-threshold methadone services.

Helped along by lawmakers who were not afraid to lead from the front, these policies resulted in making Switzerland’s HIV prevalence among people who use drugs one the lowest in Western Europe, at about 1.4 per cent.

In Portugal, the year the country witnessed 1,430 new HIV infections among people who use drugs (accounting 52 per cent of all new infections), the government introduced dramatic reforms, decriminalising all drugs and establishing model services for drug users.

Almost 10 years later, new HIV infections among people who use drugs dropped to 164 (15% of all new infections).

It was a similar HIV crisis in the UK in the mid-1980s that spurred the then-Conservative government to launch a number of harm reduction interventions that greatly reduced HIV among people who inject drugs.

Now, as Latin America faces its own supply-side crises with tens of thousands of drug-related killings, gross human rights abuses and overflowing prisons, governments are increasingly vocalising a desire to take bold action toward reform of failed prohibitionist policies. 

In 2009, the Latin American Commission on Drugs and Democracy – including the former presidents of Mexico, Colombia and Brazil, as well as leaders in journalism, politics, academia and literature – called for a paradigm shift in the approach to drugs. This was followed by a report by the Global Commission on Drug Policy that encouraged “experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of their citizens.”

Subsequently, numerous Latin American governments have openly discussed forms of regulation, including government sale of marijuana or licencing private facilities.

However, drug policy reform has always been a “two-steps forward, one-step back” undertaking and while creativity is being sought in the Americas, Europe is losing some of its pioneering spirit.

Austerity, in some contexts, is a danger to gains made in HIV prevention, among people who use drugs. In Greece, the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) warned of an increase in the number of newly identified HIV cases among people who use drugs, from between 3 and 19 a year from 2001 to 2010, to 113 new HIV cases as of July 2011.

The Greek government has increased services for drug users to address the situation but the EMCDDA cautions, that “the level of activity is still insufficient to meet the demand within the injecting drug using population.”

In other cases, a nascent abstinence-agenda is trying to manufacture a bogus tension between treatment models – suggesting that providing life-saving services to drug users, like needle-and-syringe exchange programmes, is at odds with ensuring availability of abstinence-based treatment for those who want it.

Some other lawmakers may argue that services to drug users are poor investments in lean times, ignoring the fact that it is immensely cheaper to prevent blood-borne viruses and bacterial infections like HIV, than treat them.

This is the current global paradox in drug policy.

While a new approach may indeed be rolled out to reduce black market violence in Latin America and other parts of the world, a regression to old, expensive and failed ideas in Europe may revise costly and avoidable crises from the past. 

And, perhaps, inspire some fresh thinking once again.

Kasia Malinowska-Sempruch is the director of Open Society Foundations Global Drug Policy Program

A drug user injects heroin. Photograph: Getty Images

Kasia Malinowska-Sempruch is the director of Open Society Foundations Global Drug Policy Program.

Photo: Getty
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Novelty isn't enough for Emmanuel Macron and Martin Schulz

The two politicians have caused excitement - but so far, neither has had to articulate a programme. 

Emmanuel Macron’s rally in London last night was overshadowed by polling that showed him slipping back slightly as he reaped the consequences of his excessive candour on the matter of France’s rule in Algeria.  Third with Elabe, and joint-second with centre-right candidate François Fillon with Opinionway and Ifop.

As far as the polling and French history show, what matters in this contest is the race to second-place and a ticket to the second round run-off against the hard-right Marine Le Pen.

Macron’s difficulties have intensified as this is the first Wednesday in months in which Le Canard Enchaîné has not brought fresh scandal involving Fillon and his finances. The question of why Penelope Fillon and the Fillon children were paid to act as parliamentary assistants while doing no work will run and run, however, so there may be a way back for him.

Macron’s problems have an echo in Germany, where for the first time since his return to German politics, Martin Schulz is facing serious criticism over his proposed changes to the Agenda 2010 reforms of the last SPD-led government. We wait to see what if any impact that row has on his standing in the polls.

But the difficulties of Macron and Schulz speak to a wider reason why their improved standing in the polls means that the talk of the end of the European centre-left’s crisis was just that, talk.

So far, neither of them has had to articulate a programme beyond “I’m new!” in the case of Schulz and “I’m new and attractive!” in the case of Macron.

We’ve seen that Macron, a neophyte politician, has put his foot in it when asked to add substance to his considerable style. He might improve and Fillon’s ongoing problems might give him a get out of jail free card. Schulz has been around for a bit longer but he has to keep this up until October. It’s a reminder that while being new and shiny is a useful asset for a leader – it isn’t enough on its own. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.