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.

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Italian PM Matteo Renzi resigns after referendum No vote

Europe's right-wing populists cheered the result. 

Italy's centrist Prime Minister Matteo Renzi was forced to resign late on Sunday after he lost a referendum on constitutional change.

With most ballots counted, 60 per cent of Italians voted No to change, according to the BBC. The turn out was nearly 70 per cent. 

Voters were asked whether they backed a reform to Italy's complex political system, but right-wing populists have interpreted the referendum as a wider poll on the direction of the country.

Before the result, former Ukip leader Nigel Farage tweeted: "Hope the exit polls in Italy are right. This vote looks to me to be more about the Euro than constitutional change."

The leader of France's far-right Front National, Marine Le Pen, tweeted "bravo" to her Eurosceptic "friend" Matteo Salvini, a politician who campaigned for the No vote. She described the referendum result as a "thirst for liberty". 

In his resignation speech, Renzi told reporters he took responsibility for the outcome and added "good luck to us all". 

Since gaining office in 2014, Renzi has been a reformist politician. He introduced same-sex civil unions, made employment laws more flexible and abolished small taxes, and was known by some as "Europe's last Blairite".

However, his proposed constitutional reforms divided opinion even among liberals, because of the way they removed certain checks and balances and handed increased power to the government.

 

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.