Ill-informed, ineffective, discriminatory, and ideological, drug policies became prescription for public health disaster(s), report details

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The goal was “A drug-free world.”

The certainty was “we can do it!”

And behind the goal and the certainty was a view that illicit drugs threaten “the health and wellbeing of all mankind.”

The setting was the 1998 U.N. General Assembly Special Assembly on drugs, late enough in the decades-long and ongoing international “war on drugs” to give member nations gathered there reason to consider that the mission was not only futile, but also carried its own threats to public health.

But they didn’t, and the result was an approach that equated drug use with abuse, that didn’t weigh the impact of mass incarceration on public health, that lumped drug traffickers, farmers, small scale sellers and consumers into one condemned category of miscreants, and that fueled the spread of infectious diseases. That recent history opens a Lancet report on Public Health and international drug policy published online in the last week of March, in time, its authors note, to be considered by member states participating in this April’s UNGASS on drugs.

It is a history that has been augmented by a succession of failures:  to protect public safety, to improve quality of life, to contain the spread of HIV, HCV, tuberculosis, and to lessen, let alone eradicate the use of illicit drugs, that the authors detail and follow with their recommendations of a public health oriented approach.

The most well known impacts of the zero-tolerance drug policies encouraged by the “drug-free world” aims of the 1998 UNGASS also are shown to be the most damaging, including the public health impacts of lengthy sentences in crowded prisons and of zero tolerance for the untapped benefits of proven health-protecting measures including sterile needles and syringes and uninjected opioid substitutes.

But the authors, who include former U.S. President’s Plan for Emergency AIDS Relief leader and current U.N. Tuberculosis Special Envoy Dr. Eric Goosby, former Global Fund leader and now U.N. Special Envoy for HIV in Eastern Europe and Central Asia Michel Kazatchkine, and International AIDS Society President Chris Beyrer, also highlight the impacts of shortage of services tailored to women,  of aerial drug crop spraying, and of access barriers to controlled drugs needed to relieve patients from needless agony.

Their recommendations are detailed here, and summed up in their urging, this time, for public health to shape drug policies.

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