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Two Harm Reduction Gurus Take On World Drug Policy


On International Harm Reduction Day, the heads of the Harm Reduction Coalition and the Canadian Drug Policy Coalition talk Substance.com through the tricky terrain of drug-law reforms and global politics.

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Global drug policy is entering uncharted territory. Photo via

Global drug policy is entering uncharted territory. Photo via

For people who want to see big changes to global drug laws—preferably sometime soon—the plethora of international drug policy talking shops and their apparent lack of achievement can seem frustrating. But the unfortunately-acronymed UNGASS (United Nations General Assembly Special Session) is the most important drug policy meeting of the decade. Set for New York in 2016, it will present world leaders with a high-profile chance to improve the drug-policy climate for good.

The jockeying for position in advance of UNGASS is well under way. Just this week, a report calling for an end to the global War on Drugs was released by the London School of Economics, signed by five Nobel Prize-winning economists and backed by a George Soros Financial Times op-ed—ramping up the pressure on those in power. At an inter-governmental level, language often remains cautiously coded, but change is occurring all the same.

Ready for two more acronyms? Last week, CICAD (the Inter-American Drug Abuse Control Commission)—part of the OAS (Organization of American States)—assembled in  Washington, DC, to debate drug policy in the Americas. CICAD drew government officials, army generals, judges, drug treatment specialists, NGOs and many more.

Two of those involved were Allan Clear and Donald MacPherson. Clear is the executive director of the New York-based Harm Reduction Coalition. MacPherson is the executive director of the Canadian Drug Policy Coalition and the former drug policy coordinator for Vancouver. Back from Washington, they met with Substance.com to break down what was discussed at OAS/CICAD—where the undoubted shortcomings of the forum itself were countered by the vital importance of the issues covered.

What’s the headline news from CICAD?

Allan Clear: The Organization of American States is looked upon as being ineffectual and useless—except in the last couple of years, when they were instructed by Colombia, which wants out of the War on Drugs, to produce two reports. One analyzed the state of drugs in the Americas. The other put forward four scenarios—including the path toward legalizing or decriminalizing drugs throughout the Americas.

A lot of this is stimulated because the “transit” countries are angry about what’s happening. Mexico’s really angry—obviously their death toll has been horrendous; they’re victims of the guns flowing south from the US. Then you have Guatemala, where the drugs flow up from South America—violence and gang stuff happens. These guys are all saying we need to do something different.

Uruguay isn’t that vocal—they just went ahead and legalized marijuana. And then of course we have Washington and Colorado playing into that and weakening the US government’s position: They can’t criticize Uruguay like they could previously.

So this report’s come out and suddenly the OAS has a relevance it hasn’t had for years. And the OAS secretary general, José Miguel Insulza, has taken this report and run with it. To hear him speak, you’d think the only scenario was completely restructuring our approach to drugs. He’s gung-ho about it and so is the rest of the OAS.

Donald MacPherson: Not all of them. Canada’s worse than the US. Peru is holding the line. Nicaragua’s really hardline. Panama and Venezuela too. But shortly after our scenarios meeting the Russian drug czar showed up in Nicaragua with the head of their police—I mean, on drugs the Russians are like the worst on the planet, right? So other weird politics come into it.

But Chile and Argentina aren’t too bad at the moment. Ecuador and Bolivia are good. There’s a movement, and more room for countries to find where they are on the spectrum of possible legalization. The consensus of getting away from the criminalization of possession has really gained ground…except for the US and Canada!

Allan Clear: Even the US doesn’t say, “We need to decriminalize drugs,” but they will say that we do not need to put people in prison. There are other sanctions, but if they’re not going to incarcerate people, the other option is closer to decriminalization.

One of the issues on the agenda at CICAD was “microtrafficking.” One thing that decriminalization of possession doesn’t address is what happens to people selling drugs, who also deserve our concern.

Donald MacPherson: That was a frustrating discussion. We don’t want to put these small-time guys in jail—they’re probably users, or they’re forced into it to pay their rent. So we put them through drug court. But even if you took that microtrafficker and put him in a drug court, there’s another one to take his place: It’s not going to affect the scale and scope of the market.

Even the discussion about reducing violence didn’t admit, “Well, you’ve reduced violence, but the market’s still there.” So you can never get to the bigger answer to microtrafficking: regulation.

Allan Clear: Without a regulated market—depending on enforcement alone—what things are you trying to address? You want to have a community that feels better about itself. People don’t want to be confronted by transgressive behavior, like people injecting or taking a shit in the street. They don’t want to be confronted by people who look like they’re going to shoot you, or be caught in the crossfire. So if you minimized that, took out the violent actors…

I sat next to Jim Pugel, the former assistant police chief of Seattle, and he said, “Yeah, that’s what we did.” He said there’s usually only a couple dealers who are really violent in any particular scene. Other people carry guns, but they don’t want to use them. If you take out the psychos, you reduce violence. If you move microdealing indoors, reduce the visibility of it, that goes a long way toward creating a more harmonious community.

Donald MacPherson: Exactly. Like the Dutch, who used to have “house dealers”—a house dealer was accepted by everyone, including the police. They weren’t violent; they cared about their product. If we can’t talk about regulation, let’s talk about managing the micromarket better, so there aren’t crowds of dealers fighting for street corners. It’s about the police making deals with microtraffickers, saying, “There are too many of you on this corner—spread out, be more discreet, manage your employees better!”

Allan Clear: The police role changes from one of complete enforcement to one of public safety, but they’ve got to have the willingness to take that on—which they can, when they see results. Then the discussion is put on the agenda to differentiate between big international crime gangs and the people stuck at the bottom.

One country at CICAD was saying, “We’ve caught 135 street dealers in the last month”—then saying in the next sentence, “lots of children and older people.” Yeah, you’ve really addressed crime by arresting children and old people.

Then the head of security for Argentina spoke about drug dealers in Rosario. They took 5,000 cops and helicopters and went into this neighborhood in a military-style operation. Then his next sentence is: “But we really need to focus on social integration.” Because that’s a concept that’s thrown out there—they know they have to say it. One of our Argentinian friends told us that the next day, they bulldozed all these little bunkers in Rosario where dealing took place—along with all the places where people lived. They arrested everyone, including a pregnant woman. There’s a real disconnect between the progressive language and what they’re actually doing.

Although more sensitive local policing could improve many situations, relying on police discretion is still fundamentally undemocratic, isn’t it?

Donald MacPherson: Yes. It’s not going to solve the problem.

Allan Clear: At CICAD, it’s partly a discussion of taking street-based drug users and providing social services without interactions with the criminal justice system. It’s housing-first type programs like they’ve started in Brazil, where you don’t have to be drug-free or alcohol-free to get housing.

In the US the attorney general’s office has made some sentencing reform stuff happen. The next step has to be post-incarceration: You shouldn’t be refused the ability to vote; you shouldn’t have to check that box to get a job; you shouldn’t be denied all the civil rights that an ordinary citizen gets. They’re really pushing drug courts as an alternative to incarceration.

Drug courts get very mixed feedback, don’t they? It’s either abstinence or you get punished. So while it may be a step forward from the regular court system…

Allan Clear: It may be for some, but not for all. The fact that you have to plead guilty is a major issue, too.

Donald MacPherson: Housing services are fine and dandy, but even a wealthy city like Vancouver doesn’t have all of that in place. You can’t solve the problems without addressing regulation.

So ultimately you want a legal, regulated market for all drugs?

Donald MacPherson: Yes. The Canadian Drug Policy Coalition’s two priorities are: Regulate cannabis, and decriminalize all other drugs—while we have the discussion about regulating them. Why keep drug users criminalized while you argue about how to regulate cocaine? Just remove the criminal justice system from possession of any drug, à la Portugal or the Czech Republic. It’s going to take time to regulate these things. But how can you talk about public health when you criminalize the very people you’re trying to help? So, yes: All drugs should be regulated, and decriminalization should be done tomorrow.

Allan Clear: At the Harm Reduction Coalition, we’ve always consciously avoided statements on legalization. But I think that space has opened up. Our thing is harm reduction, disease prevention and social justice, and we never worked on investigating how you regulate a market. I always thought, that will happen at some point, but that’s not my job right now.

In the early ‘90s in New York City we had people dying every week, whether they were shot or dying of an overdose or of AIDS—they died in corridors of hospitals or on the street. Then antiretrovirals came along—there are still people dying, but mainly of overdose. Now the biggest harm happening is actually incarceration: It’s the impact of prison on communities—and then the former prisoner comes out and still struggles and is still stigmatized forever. If you’re not going to put people in prison, then you have to take the criminal piece out of it. That discussion is happening at a government level now.

Donald MacPherson: What’s frustrating at the OAS is the underlying sense—and it must come from the North Americans—that drug use is the problem, not harm from use. So prevention is viewed as preventing use, not preventing harm. There was very little analysis of the two major drivers: harm from drug use and harm from drug policies.

We made a chart during the scenarios process at CICAD of, on one side, the harms of prohibition and, on the other, the benefits of prohibition. So we came up with all these prohibition harms and all these scientific references relating to HIV and the dispersal of drug markets. For the benefits of prohibition it was all belief—there was no data. Does prohibition drive the price of drugs up? Uh, actually the data shows the price of drugs going down. Does prohibition keep drugs out of the hands of children?

Allan Clear: NIDA will tell you how many 12th-graders smoke pot every single day.

Donald Macpherson: The folks promoting status quo went through the exercise and didn’t come up with any data. Zero.

Did CICAD address stigma at all, in terms of popular attitudes to drug users?

Donald MacPherson: Criminalization ensures a continuation of stigma. Nuno Capaz from the Portuguese Ministry of Health recently said that they had safe injection sites in their proposal at the beginning of their decriminalization process, as part of the health services. But it was so contentious that they took it out. But he said that now needle exchanges are not as problematic, that the stigma of harm reduction has been reduced by not criminalizing people.

Allan Clear: In Portugal criminalization deterred people from asking for health services. With decriminalization, people knew they could attend services safely. Capaz was clear that tackling stigma is an element in everything they do—he was destigmatizing help.

The discussion at the OAS happens among government officials, most of whom are unqualified on these issues—that’s part of why the discussion just limps along. At CICAD they bring in experts—that’s dubious actually—and it’s supposed to be a discussion. It’s usually not. They come with prepared statements, which betray that they don’t know anything about the issue and that they have a very fixed perspective. Also, when the panels are put together they feel compelled to “balance” them. So you have people talking about moving forward, changing the way things are, and then you have someone else who just says, “We really need drug treatment.”

Donald MacPherson: But the agenda has changed. I mean, there was a cannabis regulation panel. Things have moved on: States have made decisions, countries have made decisions. Now CICAD and the OAS have to catch up: We can’t not talk about this—it’s no longer just an idea. It’s like, “Oh, you have legalized cannabis—I guess we’d better have a session on how it’s working.” Change is happening. The conventions are irrelevant. There was a commitment to open the discussion, driven by Colombia.

It’s about educating people. “We need more drug treatment”—what the hell does that mean? What does that look like? What are the nuances? We need safe injection sites. But once you get beyond the positional stuff, people are sort of reasonable. You have Barbara Brohl from the revenue department in Colorado on a panel talking about how they’re regulating cannabis. So it’s real.

It must feel strange to see these things for the first time.

Donald MacPherson: It’s tremendous. Now you have legalization opponents like Kevin Sabet saying, “It should be stopped, we shouldn’t do it anywhere else, it’s going to be a failure”—that’s a very different position from saying, “Don’t do it.”

Ok, so there are problems with the commercialization of the cannabis market. Are they worse problems than prohibition causes? I think it would have to get pretty bad before it was worse than prohibition!

What expectations do you have for UNGASS?

Donald MacPherson: For what will be agreed upon in the room, my bars are very low. It is post-UNGASS that is important. The lack of ability to achieve consensus at UNGASS will precipitate a crisis that will threaten the whole foundation of the treaties. How will they resolve that?

Allan Clear: We saw this fracturing of consensus at the OAS and you can see the breakdown of the UN consensus process. The lowest-common denominator documents they come up with are completely inadequate to describe the situations on the ground.

At the Commission on Narcotic Drugs in Vienna this year they could not agree on the death penalty. It was horrible: Iran made a public statement about how they want to have the right to execute people. But Uruguay was brilliantly clear about why they have legalized marijuana. They said: “No one has died from marijuana. People have died from the illegality of dealing and trafficking.”

Now we have two years: The biggest drug meeting in the whole world is happening in New York in 2016. What are they going to say? Let’s put pressure on them.

Will Godfrey is the editor-in-chief of Substance.com