The opioid crisis in North America
Monday, 2 October, 2017 (Geneva, Switzerland) The Global Commission on Drug Policy today released a position paper on The Opioid Crisis in North America. With some 64,000 drug overdose deaths in 2016 in the US alone, the extent of the opioid-driven public health crisis cannot be overstated. The members of the Global Commission on Drug Policy, several of whom faced similar crises while occupying the highest levels of government in their own countries, share their views and recommendations on how to mitigate this epidemic.
Aware of the large body of work on the opioid crisis, the position paper offers an analysis and conclusions from the outside which can add to the national debates, which the United States and Canada must have. The Commission warns against cutting the supply of prescription opioids without first putting supporting measures in place and emphasizes the need to improve and expand proven harm reduction services and treatment options, including opioid substitution therapy and heroin-assisted treatment. Regulation of prescription opioids needs to become well-balanced to provide effective pain care while minimizing misuse.
The Global Commission also calls for the de facto decriminalization of drug use and possession for personal use at the municipality, city or State/Province levels. Such offenses should not be pursued, so that people in need of health and social services can access them freely, easily, and without fear of punishment. Finally, the Global Commission suggests allowing and promoting pilot projects for the responsible legal regulation of currently illicit drugs including opioids, to replace and bypass criminal organizations that drive and benefit from the current black market.
The Global Commission has called for the legal regulation of psychoactive substances since 2011, and sees in the opioid crisis a failure of regulation for medical purposes alone. The opioid crisis, characterized by a transition from licit prescription opioids via their illicit use to illicit heroin, also demonstrates the narrow and arbitrary boundaries that exist between licit and illicit substances.
Ruth Dreifuss, former President of Switzerland and Chair of the Global Commission on Drug Policy, said: “In 2017, Switzerland celebrated 25 years of heroin-assisted treatment and harm reduction policies. Drug-related deaths dropped by 50% within the first decade of implementation. There was also an 82% decrease in patients who used to sell heroin on the black market.”
Jorge Sampaio, former President of Portugal and member of the Global Commission on Drug Policy said, “In the 1990s, Portugal was experiencing heroin and HIV epidemics with open drug scenes and soaring overdose rates. We responded by changing the approach to drug addiction focusing on it first and foremost as a public health issue. This shift allowed people who use drugs to access services without fear of legal coercion. Today, Portugal has one of the lowest rates of drug overdose deaths in Europe.”
“Safe injection facilities have proven to be highly effective in preventing and reducing the harms related to drug use, when combined with other evidence-based services such as needle and syringe programs and psychosocial interventions” said Michel Kazatchkine, former Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria, and member of the Global Commission. “The United States should consider their immediate implementation, as Canada is now doing, to ease the burden of the opioid crisis on people who use drugs and the general population.”
Jorge Hernández Tinajero
Politólogo e internacionalista por la UNAM. Activista por la regulación del cannabis desde 2001; socio fundador y miembro de la Asociación Mexicana de Estudios sobre Cannabis (AMECA) primera en su tipo en México. Fundador, Presidente y Director Ejecutivo del Colectivo por una Política Integral hacia las Drogas A.C. de 2008 a 2013. Entre sus temas de trabajo e investigación sobre drogas se encuentran, además de los relativos al cannabis, reducción de riesgos y daños, estimulantes fumados, análisis de sustancias, drogas y mujeres, y drogas y derechos humanos. Actualmente realiza una investigación sobre opio y derivados en México y Colombia, enfocado principalmente a cultivo de amapola en ambos países, así como consumo de heroína en Norteamérica.