Needle exchange programme, Camden, New Jersey. AP/Mel Evans/PA Images. All rights reserved.As the dust settles after the United Nations General Assembly Special Session on Drugs (UNGASS) in April, one is left with mixed feelings about the event. This is particularly the case in relation to the increasingly important issue of drug policy metrics: how member states and the UN system measure the ‘successes’ of interventions aiming to solve what has become known in UN parlance simply as the ‘world drug problem.’
It is true that recent years have seen the emergence of a progressively more honest and sophisticated discourse surrounding the measurement of illicit drug markets. A growing appreciation of the problems associated with measuring an increasingly complex and fluid illicit market, however, has not been accompanied by a widespread and systemic appreciation that measurements of ‘success’ might be focusing on the wrong things.
Moving away from scale and flows
Such misdirected assessments take place within a conceptual framework ingrained in what can be usefully called the global drug prohibition regime: an almost universally accepted treaty-based system currently built on a suite of three UN treaties. Dating back to the first decades of the twentieth century, and in its current form as the 1961 Single Convention on Narcotic Drugs, the existing regime has dual overarching aims. These are to ensure an adequate supply of pharmaceuticals for the licit market – particularly essential medicines – and at the same time to prevent the non-scientific and non-medical production, supply and use of narcotic and psychotropic substances.
With this in mind, the system has been developed on the basis of two interconnected tenets. First, a deeply held belief that the best way to reduce the ‘world drug problem’ is to minimize the scale of – and ultimately eliminate – the illicit market and second, that this can be achieved through a reliance on prohibition-oriented and supply-side dominated measures.
Since the 1960s, such measures have relied predominantly on the activities of law enforcement agencies, and in some parts of the world, the military. On the supply-side, the traditional and, until recently, relatively widely accepted logic of this zero-tolerance approach has been that success in disrupting and ultimately halting the illicit production, manufacture and distribution of drugs listed in the conventions will reduce their availability to actual and potential consumers.
Furthermore, although the regime makes some provision for drug prevention, treatment and rehabilitation, demand reduction has been long driven by a belief that the widespread arrest of drug users and the punitive punishment of individuals caught with drugs will reduce the scale of the market by coercing current users to change their behaviour and by deterring potential users from engaging in proscribed activity in the first place.
With such ideas underpinning the operation of the regime, much attention has unsurprisingly been given to metrics with a narrow focus on arrests and prosecutions (drug dealers, traffickers and in some cases drug users), seizures (unprocessed and processed drugs including opium, coca, cannabis, cocaine, heroin, amphetamine type stimulants and precursor chemicals required for manufacture), in traditional producer states like Colombia and Afghanistan, hectares of drug crops eradicated (cannabis, opium poppy and coca) and increasingly in various parts of the world, drug processing laboratories destroyed.
Such process – rather than outcome – measurements continue to be privileged in multinational policy debates. There is, however, a growing realization in many quarters that these traditional, and relatively simplistic, indicators relating to the scale of and flows within and between illicit markets are increasingly inadequate and, in driving resources towards the wrong activities, potentially damaging. This is particularly so as we begin to understand more about the dynamic and resilient nature of markets and how they are affected by policies and interventions.
Evidence from over 50 years of enforcement-dominated drug policy has revealed few sustained and geographically widespread successes. Far from being reduced in scale and then eliminated, drug markets have survived the attention of law enforcement agencies and, in places like Latin America, the military, through adaptation. These adapted markets often cause more social harm, and in wider geographical areas, than the original markets that were subject to enforcement action. Moreover, an increasing preoccupation with elimination of the illicit market and an obsession with preventing diversion of licit drugs for recreational purposes has done much to limit access to essential medicines in some regions, particularly Africa.
A mounting appreciation of this situation has led to changes in perspective, objectives and a resultant shift in the policy landscape in some parts of the world. Armed with a better understanding of drugs, drug markets and the limitations of enforcement-oriented interventions, more and more nations, or jurisdictions within them, are moving away from a determination to simply eliminate the market (and viewing every seizure and arrest as a linear and positive step towards that goal), and shifting towards a market management approach that seeks to reduce a range of drug market related harms. Ironically, such a process has much to do with a growing appreciation of what were referred to by the Executive Director of the United Nations Office on Drugs and Crime (UNODC) in 2008 as the "unintended consequences" of the operation of the current regime.
Within this context, and inevitably driven by specific ‘local’ imperatives including the financial costs associated with law enforcement-dominated policies, increasing numbers of governments and authorities are engaging with approaches that include the decriminalisation or depenalisation of the possession of drugs, often cannabis but sometimes – as in Portugal – all controlled substances, for personal use, and health-oriented harm reduction interventions that explicitly tolerate, and seek to manage the consequences of, illicit drug use.
These include evidence-based interventions like needle exchange programmes, opioid substitution therapy, and in some instances, drug consumption rooms and controlled heroin prescription. And of course, within the United States of America and, at the national level, Uruguay, there have recently been shifts to establish legal regulated markets for recreational cannabis use. With concerns for market violence, public heath and human rights underpinning many policy shifts away from punitive prohibition comes a series of significant disconnects.
How, for example, can authorities measure the success of an intervention aiming to reduce retail market violence when the established and narrow indicators only consider figures for arrests and seizures? A similar situation exists in relation to a range of health, development and security issues across a wide array of drug markets. Furthermore, as some states realign their policy objectives and associated indicators, they become more disconnected with the dominant metrics used by the UN drug control apparatus, particularly the UNODC. Indeed, this Vienna based body is finding itself progressively more at odds with other parts of the UN system that are increasingly engaging with the drug issue and calling for revised metrics. The United Nations Development Programme is a case in point.
Metrics at the UNGASS
Amidst growing discussions around metrics, some aspects of which have been touched upon here, the UNGASS looked set to be an ideal opportunity to move discussions forward and begin to systematise within the UN the process of developing a new basket of drug policy objectives and sophisticated indicators. To be sure, overall, it seems timely to review the current measurement tools in light of what is appropriate for not only a contemporary understanding of the dynamics of drug markets and their associated harms, but also in relation to the development of innovative metrics taking place within some member states.
It is certainly disappointing that, while a number of country statements at the UNGASS openly challenged some aspects of the existing UN drug control framework, there was little discussion of the associated need for revised metrics. Nuanced dialogue was left to take place on the periphery of the meeting, particularly at a side event co-organised by New Zealand, Canada, Switzerland and Brazil and a number of civil society organisations.
Perhaps this is unsurprising. Initial promise during the drafting of the UNGASS Outcome Document, a process that took place at the Commission on Narcotic Drugs (CND) in Vienna prior to the Special Session, was short lived. For example, a combination of the consensus negotiation process, support for the status quo from states like the Russian Federation and China, and arguably a lack of understanding of the importance of metrics from other states resulted in the loss of a proposed – and relatively innocuous – paragraph in a working draft of the Document. This included a call to “identify quantifiable indicators…in line with the integrated and balanced approach”. The paragraph was shifted to the ‘car park’ designated for contested language during negotiations and failed to gain sufficient agreement for inclusion in the final text.
That said, as in a number of other areas, including those directly and indirectly relating to metrics, some positives within both the Document itself and the processes leading to it must be acknowledged. Involvement within the formulation process of a range of UN entities beyond the drug control apparatus in Vienna can only be constructive in terms of any future consideration of non-traditional drug policy indicators. Similarly, a move away from the established three-pillar structure laid out in previous UN documents (“demand reduction”, “supply reduction” and “countering money-laundering and promoting judicial cooperation to enhance international cooperation”) also offers opportunities for more sophisticated and disaggregated measurement processes, particularly in relation to access to essential medicines.
In terms of specific metrics, it is good that the Document also includes mention of the target to end the HIV epidemic by 2030 “among people who use drugs”. Furthermore, that the Outcome Document – and many country statements in New York – explicitly welcomes the Sustainable Development Goals (SDGs) as “complementary and mutually reinforcing” to drug control, and recommends “the use of relevant human development indicators” provides a valuable toe-hold for the future development of metrics that not only move beyond law enforcement process indicators, but also enhance system-wide coherence on the issue.
Linking new and carefully designed indicators to broader UN objectives, principles and contemporary UN endeavours, such as the Sustainable Development Agenda agreed in late 2015, would do much to bring international drug control policy more in line with the UN Charter and other instruments, including those concerning indigenous rights. Any serious discussion of the measurement of drug policy impacts within the broadly defined development domain must read across to relevant SDGs indicators.
With all this in mind, and viewing the development of new metrics as a process rather than an event, it is perhaps prudent then to admit that while the UNGASS was undoubtedly a missed opportunity, the Outcome Document and the ‘mood music’ accompanying its adoption in New York offer the foundations for future dialogue, and hopefully action.
Between now and the next high-level UN review of drug policy in 2019, efforts should be made to incorporate discussions within CND sessions that include a range of relevant UN agencies. Additionally, much could be gained from encouraging discussion of drug policy metrics and outcomes in other UN forums, including the World Health Assembly, as well as bringing the UN Statistical Commission into a review process. Such moves should certainly connect with the expertise present within the UNODC and build upon the welcome refinement of its approach to measuring the illicit market.
The broadening of the current narrow indicators favoured at the multilateral level to incorporate health, development and security outcomes would help facilitate the further implementation of more effective drug control policies and interventions at local, national, regional and international levels and break the current metrics trap. Moreover, inclusion within the review process of proficiency and data sets within UN agencies in addition to the UNODC, including UNAIDS, WHO, UNDP and the Office of the High Commissioner on Human Rights would contribute to the reduction of systemic dissonance around drugs and the continuing – although declining – isolation of Vienna.
The challenge over the next three years is to ensure that momentum is maintained and that the UNGASS is used as a springboard for action rather than an obstacle to the implementation of evidence and rights-based drug policies.
This article is published as part of an editorial partnership between openDemocracy and CELS, an Argentine human rights organisation with a broad agenda that includes advocating for drug policies respectful of human rights. The partnership coincides with the United Nations General Assembly Special Session (UNGASS) on drugs.
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