Polak's question: Round 3
It seems HCLU’s Silenced NGO Partner video (with more than 35.000 views on YouTube up to now) on the duel between Mr. Antonio Maria Costa, the head of the UN Office on Drugs and Crime and the Dutch psychiatrist Mr. Frederick Polak caused some disturbances in the still water. We learnt that our video was not only popular among Dutch government officials, but also among staff members of various UN agencies, including UNODC itself. Mr. Costa recently travelled to the Netherlands, where he made an official visit to one of the world famous Dutch coffee shops and a controlled injection site, and met with local authorities. Maybe it is an exageration to say that this visit was provoked by our video, but it seems the UN drug czar and his office feels the pressure from civil society. The Dutch drug policy model is the only living proof in our world that the legal availability of cannabis does not necessary result in skyrocketing demand. As Mr. Polak pointed out earlier, the sole existence of the coffee shop model is a threat to the global prohibiton regime.
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The assumption that UNODC feels the urge to respond to criticisms was affirmed by Mr. Costa himself at the international harm reduction conference this year, held in Barcelona from May 11-15 (read a summary of his speech below). After Costa’s speech, Polak had the opportunity to challenge him again. He reformulated his question this time, asking Costa what did he learn during his visit in the Netherlands. Mr. Costa answered that the city of Amsterdam “is characterized by rates of drug addiction – I m referring to cannabis use – three times greater than anywhere else in Europe”. UNODC is preparing a discussion paper on this issue, to be published soon, which concludes: “availability causes use”. This paper has not been published yet, but we asked Dr. Alex Wodak, a well-known Australian psychiatrist and researcher, a long time supporter of harm reduction, to comment this statement. Dr. Wodak says that Mr. Costa is “simply objectively wrong” in claiming that the level of use is higher in the Netherlands than in the rest of Europe. He also referred to a study by Peter Cohen and Craig Reinarmen, based on a comperative analysis of drug policies and the levels of cannabis use in two cities: Amsterdam and San Francisco. The researchers found no evidence that different drug policy approaches had a significant impact on the level of cannabis use, the prevalence of cannabis use is higher in the United States, despite its War on Drugs policy. Here is what the study says about the comparison of use levels:
"The overall response rate of the San Francisco prevalence survey was 52.7%, which yielded a sample of 891.28 Of these respondents, 349 reported that they had used cannabis 25 or more times ( 39.2% of the population sample and 3 times the prevalence found in the Amsterdam sample) ..."
Craig Reinarman, Peter D.A. Cohen and Hendrien L. Kaal, "The Limited Relevance of Drug Policy: Cannabis in Amsterdam and in San Francisco"American Journal of Public Health| May 2004,Vol 94, No. 5, 837.
This means that cannabis use levels in the "punitive" San Francisco were 3 times higher than in the "liberal" Amsterdam!
What is more, if we compare the two cities, 51% of people who had smoked cannabis in San Francisco reported they were offered heroin, cocaine or amphetamine the last time they purchased cannabis, but only 15% of Amsterdam residents who had smoked pot reported the same. What matters is not simply consumption levels, points out Dr. Wodak, but the harms caused by drugs (and drug policies). The indicators of death, disease and corruption are much better in the Netherlands than in Sweden for instance, a country praised by UNODC for its “succesful” drug policy.
|SUMMARY OF COSTA’S SPEECH|
Mr. Costa adressed the conference in a keynote speech on Thursday, which was the most progressive he has ever made. (Actually we heard a gossip that the title of the first version of his speech was “Harm Reduction: A Controversial Issue”, which was modified by his staff one day prior). He said that the drug control system focused mostly on law enforcement in the past couple of decades, rather than focusing on public health, causing “suspected but unintended” consequences. “The first and foremost unintended consequence was that public health, which actually is implied in the drug conventions as the first principle, was pushed in the background, and was more honoured in lipservice and rhetorics than in the practice,” said Mr. Costa. “Indeed, when it comes to drug control, and looking again at the reality, or at the budget commissions in our countries, spending on public security has been a multiple of several times of what was spent on public health”. Instead of a comprehensive and health-centered staregy drug policies chosed to pursue short term, ideology-based solutions, leaving “the public confused and drug addicts neglected”. Therefore we have “to go back to the roots of drug control, read the conventions once again, apply the conventions exhaustively, and put health at the center stage of drug control”.
He acknowledged that there is no chance to stop drug trafficking in the short term, even if his dream is a world free of drugs and poverty. He emphasized that here are 25 million heavily dependent persons, who are not able or unwilling to stop drug use, therefore we need harm reduction in addition to demand and supply reduction. “In addition to alternative development, so that we stop the farmers, law enforcement, so that we stop traffickers, prevention and treatment, so as to prevent people from falling to the drugnet of drug addiction, we must mitigate the negative consequenes of drugs, both for those who suffer from dependence, as well as for society at large.” said the head of UNODC. “In particular we have to mitigate the risk that drug abuse will lead at least in some countries to the HIV pandemic related to injecting drug use.” He reported that the HIV/AIDS department of UNODC is the fastest growing program of the agency, and invited the audience to applaud for Christian Krol (UNODC’s coordinator for HIV/AIDS) and his team.
One of his remarks seemed to be a reference to his debate with Mr. Polak: “We want results, not discussion, not rhetorics, not endless debates.” He criticized again fashion models “who snort or sniff or lick drugs” and are idolized by the media. He invited NGOs to participate in the discussion forum organized by the Vienna NGO Committee in July 2008, which aims to calalyze civil society contribution to the UNGASS review process. He repeated his statement made first at the CND in March on the condemnation of death penalty against drug offenders: “I strongly believe that altough drugs kills we should not kill because of drugs”. He quoted the words of the International Covenant on Civil and Political Rights: “countries which have not abolished the death penalty, sentence of death may be imposed only for the most serious crimes”.
PERSONAL NOTE: I appreciate the recent positive changes in UNODC’s attitudes to harm reduction and people who use drugs. However, I think there are at least two major contradictions in this speech. First, Mr. Costa calls to put an end to the neglect of "drug addicts" (not very nice terminology) and respect for their human rights – at the same time he does not condemn criminal laws that are major factors behind the discrimination and stigmatization of drug users. Second, he says public health should be restored to its place at the heart of drug control. At the same time, he claims his agency is “not a public health institution”. If drug control is a public health quest, how comes that the UN agency responsible for coordinating global drug control efforts is not a public health agency? I believe in evolution, and I hope that these controversies are only symptoms of the infantile sickness of the drug control regime, which is moving from prohibition to harm reduction.
Posted by Peter Sarosi