Wednesday, November 18, 2009

Harm reduction and human rights; the need to mainstream Human rights in policy making

Cover slide

MENHARA FIRST REGIONAL CONFERENCE ON HARM REDUCTION / Beirut – Lebanon (16 to 18 November 2009)

 

Harm reduction and human rights; the need to mainstream Human rights in policy making 

Elie Abouaoun (DDS), Beirut Lebanon

Introduction: the dilemma 
·         Many social debates are still unresolved and might never be resolved such as the right balance between “the need for security” and “ the need to respect human rights”
·         Many people say that “security” cannot be gained by giving up on the respect of human rights
·         The same applies to the debate between the prevalence of “security” on “development”
·         Can we achieve development without security? Can we achieve “security” without “development”
·         Taken from a broader perspective, “security” includes “safety”
·         The “blame the victim” policy continues to dominate most of the responses to drug use as many other social problems
·         In 1920, the US congress prohibited alcohol
·         In 1933, the US congress recognised that prohibition failed because not only it did not drop the drinking rate but it increased the crime rate and the prison population
·         However, in approaching this type of social problems, extrapolation is not a valid methodology
·         The success or failure of various approaches to social problems are context specific
·         Assuming this, shall we fight wars regardless of the human horrors they might cause?
·         This type of debates is usually “ideologically” charged and engaging into the debate most often raises more questions than answers.
·         This presentation will not be an exception to this rule. The expectation is that the questions it will raise will guide your debates in the coming days
Drug users are victims 
·         The desperation of some persons due to any type (psychological, medical, social, economical…) of vulnerability leads to self-destructive practices
·         Addicts are viewed as the unfortunate victims of “vulnerability”, “greedy corporations”, “corrupt policies and politicians”…
·         So drug users are vulnerable people, and hence are victims
·         Drug abuse is a problem, for those involved in it and for their family and friends.
·         It affects therefore all the society and not only those directly involved in it
·         So dealing with the problem needs to be multi levelled
o    Moral
o    Medical
o    Legal
o    Social
o    Educational
o    Economical…etc. 
·         What is sure however is that it is not an exclusive criminal problem
The “rights: dimension(s) of the problem
·         There are more than one dimension related to human rights
·         Some human rights violations lead to an increase in drug use:
o    Lack of access to information
o    Lack of access to health care
o    Poverty / unemployment
·         Inappropriate policies (mainly the “blame the victim” approach) also lead to numerous violations of the Human dignity:
o    Right to be protected from degrading or inhumane treatment (harassment, illegal searches, torture…etc.
o    Non-Discrimination / equality
o    Access to basic services (education, health, employment)
o    Right to the Highest Attainable Standard of Health (HASH)
o    Right to privacy
·            At the same time, people have the right to expect from their respective governments to protect them from social problems including drug abuse
·            They have the right to expect a society free from drugs and other associated/dangerous problems
·            On another hand, the link between drug use and criminality is more a symptom than an evidence set in stone
Pro harm reduction
·         Is the possession of few grams of drugs more dangerous than the rape of a ten-year-old, the burning down of a building occupied by people, or the killing of another human being?
·         Most of the anti-drug/prohibition programmes lead to more violations than solutions and in some cases become a cover for violating people’s rights and freedom
·         The exclusive “law and order” approach might be appropriate for the organized drug trade
·          However, most of the people prosecuted are, in fact, casual users and petty dealers
·         Harm reduction accepts that illicit drug use has been, and will continue to be, a feature of cultures throughout the world, and that efforts should be made to reduce harms among individuals who continue illicit drug use
·         Harm reduction is a pragmatic and humanistic approach to diminishing the individual and social harms associated with drug use
·         It seeks to lessen the problems associated with drug use through methodologies that safeguard the dignity, humanity and human rights of people who use drugs
·         The available evidence demonstrates that enforcement has failed in general to achieve its stated goals of decreasing drug use and improving public order. In some cases, it actually fuels risky injection
·         Criminalization leads to:
o    Marginalization of addicts who are pushed to commit crime
o    Black market and parallel layers
o    Waste of resources because it costs more than other alternatives
o    Break up of families
Pro prohibition approach 
·         Non-drug users, especially children, as defined by Article 33 of the United Nations Convention on the Rights of the Child, are entitled to live in a safe, secure, drug-free environment, and to have their human rights protected by society
·         The drugs and crime nexus imposes a stiff approach of law and order/prohibition
·         The drug abuse:
o     limits human potential
o    threatens the safety and well being of children and unborn children
o    diminishes freedom to choose
o    leads to addiction and chemical slavery
o    creates an inequity in society for those who choose not to use drug
Role of the rights/advocacy groups 
·         Obviously, rights groups need to be focused and specific in what they advocate for
·         Getting into the technicalities of the debate will dilute the message
·         The key messages could include:
o    Drug users are victims and not criminals
o    As a social group, they suffer from rights deprivations, discrimination, and stigmatization and therefore have a legitimate claim to the protective services of the human rights community
o    Conventional prohibition policies generate in most of the cases more violations than solutions
o    All policies should take equally into account the rights of the drug users and the rights of the non-drug users to be protected from a proliferation of drug use
·         Potential actions of rights groups:
o    Awareness activities on the rights dimension of the problem
o    Advocacy activities to promote right friendly policies
o    Legal defence to individuals prosecuted for drug use, especially in context where the violations of rights is a common practice
Guidelines for a rights friendly policy making 
·         Policy makers should put themselves in the shoes of drug users as victims
·         Policies based on judgemental approaches (criminals…) will widen the divide and will never lead to solutions
·         Main stream human rights of both users and non-users in all related policies
·         Allocate significant resources to the adopted policies keeping in mind the low cost effectiveness of excessive prohibition policies
·         Adopt a multileveled approach (medical, legal, social, moral, educational, economical…)
·         Adopt an inclusive approach (Involving all stakeholders including the community) in all phases of the policy development, implementation, monitoring and evaluation