Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,What does effectivedrug policy mean?,Ralf Jrgens,Canadian HIV/AIDS Legal Network,Todays Presentation,Drug-related harm in Canada and in the world,From prohibition to harm reduction,A multi-faceted response:the“four-pillar approach,Harm-reduction:an ethical imperative,Harm-reduction:a legal imperative,Examples of pragmatic drug policy,Effective drug policy:the way forward,Facing up to an epidemic,Drug users are citizens:they include our sons,daughters,brothers and sisters and,increasingly,our parents.They deserve humane responses;let us not wage war on them.,Margaret Hamilton,1999,Background,Over 125,000 Canadian inject illicit drugs,In 1993 Canadian researchers warned that an explosive HIV epidemic was about to occur,Governments failed to respond with appropriate measures,HIV&hepatitis C outbreaks,and overdose deaths reached epidemic proportions in several municipalities,In 1997,an annual HIV incidence rate of 18%was observed among injection drug users in Vancouver,Injection drug users now account for 26%and 63%of new HIV and hepatitis C cases respectively,Background,Human and Fiscal Suffering:,Endocarditis:$25,000 per case,Overdoses:$500,000 in ambulance costs in the Downtown Eastside of Vancouver alone(annually),HIV:Lifetime per case=$150,000;HCV infection expected to be much higher,Additional Costs:Emergency room visits,acute hospital bed use,physician costs,laboratory costs,ALL PREVENTABLE!,Background,From prohibition to harm reduction,criminal laws to control illicit drugs and their use have been in place since the early 1900s,the current statute was enacted in 1996,it prohibits import or export of illegal drugs,as well as possession and trafficking,From prohibition to harm reduction,recognition that prohibitionist policies are ineffectual in stopping drug use and have several negative consequences:,they encourage users to inject quickly,out of fear of police apprehension,compel users to inject with unclean equipment or to inject in unsafe and unhygienic circumstances,produce an underground market for drugs,associated with crime and corruption,create a culture of,marginalized,and stigmatized people who are difficult to reach,undermine community caring,by fostering public attitudes that are vehemently ant-drug and anti-drug users,From prohibition to harm reduction,The Canadian federal governments stated position for two decades has been that,“the criminal law should be employed to deal only with that conduct for which other means of social control are inadequate or inappropriate,and which interfere with individual rights and freedoms only to the extent necessary for the attainment of its purpose.,(Government of Canada.The Criminal Law in Canadian Society,Aug 1982),Such a position lends support to proposals for a drug policy based on harm reduction principles.,From prohibition to harm reduction,evidence that Canadian policy has shifted towards harm reduction philosophy:,Canadas Drug Strategy adopted in 1998 states that its goal is to reduce the harm associated with drugs to individuals,families,and communities,Strategy further states that because“substance abuse is primarily a health issue rather than an enforcement issue,harm reduction is considered to be a realistic,pragmatic,and humane approach,Special Senate Committee on Illegal Drugs established in 2000 to“develop a national harm reduction policy,In 2001,Canadas ministers of health“acknowledged a report that set out a harm reduction approach and framework for action.,From prohibition to harm reduction,further evidence that Canadian policy has shifted towards harm reduction philosophy:,In 2001,then Minister of Health Allan Rock recognized that“changes are needed to existing legal and policy frameworks-both national and international-in order to effectively address IDU as a health issue,In the interim,before these changes are made,the Minister advocated for harm reduction measures within the existing legal framework.,The“four-pillar approach,Prevention,focuses on education regarding substances,Treatment,includes numerous interventions and support programs,including detoxification,counselling,social programs,and medical care,Enforcement,consists of efforts to curb the supply of drugs,Harm reduction,involves interventions that focus on decreasing the negative consequences of drug use for communities and individuals,Harm reduction:an ethical imperative,the criminal approach to drug use has,failed to achieve the goals for which it is designed and promoted,excluded those who inject drugs from the community,misused limited resources,stimulated the rise to power of socially destructive and violent empires;,adopting an ethic of harm reduction acknowledges that prohibitionist approaches to drug use have not worked,it is deemed unethical to demand from someone something of which they are physically or mentally incapable,Harm reduction:a legal im