Peter Sarosi Hungarian Civil Liberties Union (HCLU) Dialogoue on Drug Policy 8 June, European and Hungarian drug policies: based on evidence?

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EU drug policies are often contrasted with U.S. drug policy as an example of a „balanced”, „integrated” and „science based” approach: 1. Proper balance between law enforcement and public health interventions 2. Interventations are the results of a strategic, integrated approach to drug problems 3. Measures taken by governments are based on scientific evidence Is this a dream or reality?

Aims of the EU Drug Strategy ( ) 1. to reduce significantly over five years the prevalence of drug use, as well as new recruitment to it, particularly among young users under 18 years of age 2. to reduce substantially over five years the incidence of drug-related health damage (HIV, hepatitis, TBC etc.) and the number of drug-related deaths 3. to increase substantially the number of successfully treated addicts 4. to reduce substantially over five years the availability of illicit drugs 5. to reduce substantially over five years the number of drug- related crimes 6. to reduce substantially over five years money-laundering and the illicit trafficking of precursors

Evaluation of drug strategy by EMCDDA, No decrease in life prevalence, in some countries there is an increase 2. Slight decrease in drug related deaths, stabilizing HIV/AIDS situation 3. There is an increase in treatment demand – no data on the success rate 4. Quantity of seized drugs increased, no decrease in access to drugs 5. Drug related crime is growing 6. No decrease in precursor trafficking, number of money laundering transactions is on the rise

Conclusions Interventions aimed to eliminate or significantly reduce drug phenomenon as such doomed to be a failure → no reduction in supply or in demand Interventions aimed to eliminate or significantly reduce drug phenomenon as such doomed to be a failure → no reduction in supply or in demand Public health and social interventions to reduce problem drug use and other related harms are succesful → treatment and harm reduction Public health and social interventions to reduce problem drug use and other related harms are succesful → treatment and harm reduction DRUGS ARE HERE TO STAY – BUT THE HARMS OF DRUG USE CAN BE PREVENTED AND TREATED

Member states and the European Commission ignored the findings of the EMCDDA No scientific forum or public discussion on the previous strategy to find alternatives No scientific forum or public discussion on the previous strategy to find alternatives No involvment of civil society in the preparation of the new drug strategy No involvment of civil society in the preparation of the new drug strategy The new drug strategy ( ) is based on the same principles as the previous: The new drug strategy ( ) is based on the same principles as the previous: 1) main goal is to eliminate or significantly reduce drug phenomenon 2) Social and public health interventions (2 pages) are subordinated to law enforcement interventions (5 pages) IS EU DRUG POLICY AS SUCH BASED ON SCIENCE?

There is no consensus on drug policy in European level → if we want to find best practices for science based interventions we have to search them in national/local level MAIN TRENDS: Social and public health policies becoming more important in most countries Social and public health policies becoming more important in most countries Legislation tends to decriminalize drug possession and focus on supply reduction Legislation tends to decriminalize drug possession and focus on supply reduction Some cities are experimenting with innovative ways to provide access to illicit drugs Some cities are experimenting with innovative ways to provide access to illicit drugs THERE IS A CONTRAST BETWEEN PROGRESSIVE LOCAL DRUG POLICIES AND UN/EU DRUG POLICIES

Examples of best practices Best practice #1: heroin maintenance (Switzerland, Netherlands, Germany, Spain) → both clients and society experienced significant benefits (e.g. reduced number of mortality and morbidity, crime and unemployment, housing problems etc.) (Uchtenhagen, 1997; Jürgen Rehm at al, 2001) Best practice #2: pill testing (Austria, Germany, Spain etc.) → best contact with party goers, prevention of accidents and infections, monitoring illicit drug markets (EMCDDA report, 2001) Best practice #3: supervised injection sites (Germany, Netherlands, Spain) → reduction of blood born infections, ODs and street drug use (EMCDDA report, 2004)

According to scientific evidence repressive drug policies do not result less drug use than lenient drug policies

However, there is a difference in the impacts of different drug policies on problem drug use Prevalence of drug use is higher in the Netherlands than in Sweden, but the prevalence of problem drug use is almost double in Sweden (4 per ), where injecting drug use and related health problems are on the rise Prevalence of drug use is higher in the Netherlands than in Sweden, but the prevalence of problem drug use is almost double in Sweden (4 per ), where injecting drug use and related health problems are on the rise There is a signficant difference in the quality of life and health of drug users in countries with different drug policies There is a signficant difference in the quality of life and health of drug users in countries with different drug policies Less repressive drug policies result in less public health and social damage related to drug use/trafficking Less repressive drug policies result in less public health and social damage related to drug use/trafficking

COMPARISON OF SOME SUCCESS INDICATORS OF U.S. AND DUTCH DRUG POLICIES Lifetime prevalence of marijuana use (ages 12+) 2001 US: 36.9% Netherlands: 17.0% Lifetime prevalence of marijuana use (ages 12+) 2001 US: 36.9% Netherlands: 17.0% Past month prevalence of marijuana use (ages 12+) 2001 US: 5.4% Netherlands: 3.0% Past month prevalence of marijuana use (ages 12+) 2001 US: 5.4% Netherlands: 3.0% Lifetime prevalence of heroin use (ages 12+) 2001 Lifetime prevalence of heroin use (ages 12+) 2001 US: 1.4% Netherlands: 0.4% Incarceration Rate per 100,000 population 2002 Incarceration Rate per 100,000 population 2002 US: 701 Netherlands: 100 Per capita spending on criminal justice system (in €) 1998 US: €379 Netherlands: €223 Per capita spending on criminal justice system (in €) 1998 US: €379 Netherlands: €223 Homicide rate per 100,000 population Average US: 5.56 Netherlands: 1.51 Homicide rate per 100,000 population Average US: 5.56 Netherlands: 1.51

There are major differences between the drug policies of Central-Eastern Europe (except Slovenia and Czech Republic) and Western Europe The legislation is more repressive in new member states The legislation is more repressive in new member states Less resources and appreciation for public health policies Less resources and appreciation for public health policies Limited access to social and health care for drug users Limited access to social and health care for drug users Greater risks of problem drug use (morbidity, mortality) Greater risks of problem drug use (morbidity, mortality) Moralistic and not pragmatic approach to drug users Moralistic and not pragmatic approach to drug users

WHO ARE THE PEOPLE WE ARE CRIMINALIZING? 91% of offenders were simple users – only 6-8% of offences are linked to significant amount of drugs 91% of offenders were simple users – only 6-8% of offences are linked to significant amount of drugs 97% of offenders are less than 30 y.o. 97% of offenders are less than 30 y.o. 70% has no previous criminal record 70% has no previous criminal record Every sixth offender is under 18 Every sixth offender is under 18 Drug offenders are the most educated group among all offenders Drug offenders are the most educated group among all offenders THE PRIZE OF RESTRICTIVE DRUG POLICIES: 1) Thousands of otherwise law abiding citizens conflict with the law (non-problematic users) 2) Limited access to social and health care for problem users

„Worst practices” from Hungary Police raids against dance clubs → hundreds of young people searched and arrested, few drugs seized, no dealers caught Police raids against dance clubs → hundreds of young people searched and arrested, few drugs seized, no dealers caught Police searches against clients of needle exchange programs → according to the Prosecutor General needle exchange is a crime Police searches against clients of needle exchange programs → according to the Prosecutor General needle exchange is a crime Alternative treatment → thousands of non-problematic drug users are refered to treatment programs by the criminal justice system while the budget for life saving services is very limited Alternative treatment → thousands of non-problematic drug users are refered to treatment programs by the criminal justice system while the budget for life saving services is very limited COSTS/RISKS > BENEFITS BAD ALLOCATION OF RESOURCES VIOLATION OF HUMAN RIGHTS

CONCLUSIONS European drug policies are far from being evidence based, but comparing with U.S. drug policy there is a significant progress, especially in the local level European drug policies are far from being evidence based, but comparing with U.S. drug policy there is a significant progress, especially in the local level The balance between law enforcement and public health is still not appropriate – limited access to services, violation of human rights of drug users The balance between law enforcement and public health is still not appropriate – limited access to services, violation of human rights of drug users The need for progress is especially urgent in Central-Eastern Europe → decriminalization of drug use can lead to better allocation of resources and more focus on (voluntary!) prevention, treatment and harm reduction The need for progress is especially urgent in Central-Eastern Europe → decriminalization of drug use can lead to better allocation of resources and more focus on (voluntary!) prevention, treatment and harm reduction

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