Implementing a health-led approach to drug use – what does it mean?
by Lucy Dillon

In the Programme for Government published in May 2016, a commitment was made to ‘support a health-led rather than criminal justice approach to drug use’ (p. 56) 1. On 17 November, CityWide Drugs Crisis Campaign held a seminar to explore what this commitment means in practice and what implementing such an approach in Ireland would involve. Decriminalising the possession of drug use was at the core of much of the discussion. There were presentations from three key speakers:2 Ann Fordham, executive director of the International Drug Policy Consortium (IDPC); Niamh Eastwood, executive director of Release;3 and, Aileen O’Gorman, sociologist and senior lecturer at the University of the West of Scotland.

 

World drug policy

Ann Fordham’s presentation focused on the United Nations General Assembly Special Session (UNGASS) on the world drug problem, held in April 2016. She emphasised the move towards a much more health-led approach to drug policy in a number of countries and regions, which had manifest itself in decriminalisation and legalisation in some cases. Despite having grave reservations about UNGASS and its outcome document, she identified important progress made on a range of issues, including health, human rights, gender, and development.4

 

Decriminalisation

Niamh Eastwood’s presentation, ‘Decriminalisation, Moving the Debate On, Dispelling the Myths’, made the case for the removal of criminal sanctions for the possession of drugs, i.e. decriminalisation. She presented evidence to debunk what she saw as two key myths in the decriminalisation debate: ‘criminal justice responses and criminalisation deters drug use’; and, ‘decriminalisation sends a “message” [that] drug use is ok’. Eastwood argued that reducing harms should be the primary goal of drug policy. When noting both the number of drug-related deaths and recorded drug possession offences in Ireland, she emphasised the associated harms of both to the individual user, their families, and the wider community. The positive social and economic impacts of decriminalisation in Portugal, California and some areas of Australia were discussed to illustrate the benefits of decriminalisation. In terms of the practicalities of implementing decriminalisation, three elements that would need to be addressed by any associated policy or legislation were discussed in an international context. These were: the threshold quantity to determine personal possession; the role of the decision-makers, such as police or service providers, in assessing the quantity and the relevant course of action; and, any sanctions for those found to be in possession of a drug.

 

Social inclusion pillar

Aileen O’Gorman made the case for a social inclusion pillar in the forthcoming National Drugs Strategy (NDS). She spoke about how in Ireland drug use disproportionally harms people who also experience a range of problems rooted in poverty and inequality. Since the start of the economic downturn in 2008, these groups had been particularly vulnerable to what she termed ‘policy induced losses’. These are the negative outcomes experienced by people as result of changes, or a lack thereof, to local and national policy. She argued that ‘a health-led approach to drug use would provide an opportunity to address the social and structural determinants of drug-related harm’. There are a number of advantages of including a social inclusion pillar as part of the forthcoming NDS. For example, it could include a requirement that other public policies be ‘drug proofed’. This would mean that policies in other areas, such as education and housing, would have to be assessed to ensure that they would not impact negatively on drug-related harms.

 

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  1. Department of the Taoiseach (2016) A Programme for a Partnership Government. Dublin: Government Publications Office. Available at http://www.drugsandalcohol.ie/25508/
  2. The three presentations can be found at http://www.drugsandalcohol.ie/26491/ 
  3. Release is a UK-based charitable organisation that is a ‘national centre of expertise on drugs and drugs law’. http://www.release.org.uk/about
  4. A summary of the IDPC’s written response to UNGASS, upon which this presentation was based, is available in issue 60 of Drugnet Ireland. http://www.drugsandalcohol.ie/26701/