AGENDA: CONSUMPTION, CONSEQUENCES AND REGULATION OF PSYCHOTROPIC SUBSTANCES

A) Introduction

1. What are Psychotropic Substances? The expression psychotropic substance is a legal term and refers to those natural or synthetic substances or any natural material listed in the four schedules of the 1971 Convention (originally 32 substances, at present 115 substances). The salts of those substances, where they exist, as well as preparations (see definition in paragraph 83) containing those substances, are subject to the same control requirements as the base substance. Psychotropic Substance refers to a chemical substance that crosses the blood-brain barrier and acts primarily upon the central nervous system where it alters brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior. These drugs may be used recreationally, to purposefully alter one's consciousness, as entheogens for ritual or spiritual purposes, as a tool for studying or augmenting the mind, or therapeutically as medication.

2. International Law and Psychotropic Substances

A) Single Convention on Narcotic Drugs, 1961 The adoption of this Convention is regarded as a milestone in the history of international drug control. The Single Convention codified all existing multilateral treaties on drug control and extended the existing control systems to include the cultivation of plants that were grown as the raw material of narcotic drugs. The principal objectives of the Convention are to limit the possession, use, trade in, distribution, import, export, manufacture and production of drugs exclusively to medical and scientific purposes and to address drug trafficking through international cooperation to deter and discourage drug traffickers.

B)

Convention on Psychotropic Substances, 1971

The Convention establishes an international control system for psychotropic substances. It responded to the diversification and expansion of the spectrum of

drugs of abuse and introduced controls over a number of synthetic drugs according to their abuse potential on the one hand and their therapeutic value on the other.

C)

Narcotic Drugs and Psychotropic Substances, 1988

This Convention provides comprehensive measures against drug trafficking, including provisions against money laundering and the diversion of precursor chemicals. It provides for international cooperation through, for example, extradition of drug traffickers, controlled deliveries and transfer of proceedings. D) The Commission on Narcotic Drugs: its mandate and functions The Commission was established by the Economic and Social Council in its resolution 9 (I) of 16 February 1946 as the central policy-making body within the United Nations system dealing with drug-related matters. The Commission analyses the world drug situation and develops proposals to strengthen the international drug control system to combat the world drug problem. E) The International Narcotics Control Board (INCB ) is the independent and quasi-judicial monitoring body for the implementation of the United Nations international drug control conventions. It was established in 1968 in accordance with the Single Convention on Narcotic Drugs, 1961. It had predecessors under the former drug control treaties as far back as the time of the League of Nations.

3. Nature and Extent of Drug Use Globally, UNODC estimates that between 155 and 250 million people, or 3.5% to 5.7% of the population aged 15-64, had used illicit substances at least once in the previous year. Cannabis users comprise the largest number of illicit drug users (129-190 million people). Amphetamine-type stimulants are the second most commonly used illicit drugs, followed by opiates and cocaine. However, in terms of harm associated with use, opiates would be ranked at the top. At the core of drug use lie the problem drug users; those that might be regular or frequent users of the substances, considered dependent or injecting and who would have faced social and health consequences as a result of their drug use.

Based on the global estimates of cannabis, opiate, cocaine and amphetamine-type stimulant users, and using the relative risk coefficient,5 it is estimated that in 2008, there were between 16 and 38 million problem drug users (between 10%-15% of estimated drug users) in the world. The broad range of the estimate reflects the uncertainties in the available data globally. Types of Drug use Scientific evidence indicates that the drug use is a result of a complex multifactorial interaction between repeated exposure to drugs, and biological and environmental factors. In recent years, the biopsychosocial model has recognized drug dependence as a multifaceted problem requiring the expertise of many disciplines. A health sciences multidisciplinary approach can be applied to research, prevention and treatment of drug use. a) Recreational Some forms of drug use are associated with recreational settings or specific subpopulations, for example, ecstasy use, which is found more among young people and associated with particular lifestyle and events (parties, nightclubs and dance events) seen in many affluent societies. Also among those who use drugs in recreational settings, a significant proportion could be induced to substance abuse with the purpose of coping with anxiety, poor emotional skills, poor capacity to manage stressful stimuli and difficult environmental situations, poor engagement in school and lack of vocational skills. b) Society, family, life experience Use of opiates, cocaine, amphetamine and methamphetamine, and those injecting, account for a substantial proportion of dependent or problem drug users (however defined). These drug users also tend to be more chronic users, with associated psychiatric and medical co-morbidities, and are either stigmatized or come from marginalized segments of society. Many studies have shown a strong association between poverty, social exclusion and problem drug use. Studies also suggest the possibility that childhood experiences of neglect and poor parent-child attachment may partially contribute to a complex neurobiological derangement and dopamine system dysfunctions, playing a crucial role in susceptibility to addictive and affective disorders. c) Psychiatric disorders Further studies have shown that individuals with lifetime mental disorder were three times more likely than others to be dependent on substances. Patients suffering from bipolar disorders (manic-depressive disorders) are more likely to be using psychoactive substances compared with those suffering from unipolar major depression.4 On the other hand, use of psycho-stimulants such as amphetamine or cocaine and cannabis can also induce psychotic like symptoms in users.

Questions to Consider:

1. How do demand reduction strategies vary for each type of drug-user? 2. How are needs of problem drug users different from others who consume drugs?

B) Problems related to Use of Psychotropic Substances 1. Economic and Political Consequences of Illicit Drug Production a) Illicit drug production prevents long-term economic growth While there is evidence that sales of illicit drugs can foster economic development in the short term, the question remains whether that leads to a process of sustainable development in the long term. Available evidence shows that the countries in which illicit drugs have been produced have suffered a decline in economic growth. The most obvious explanation for the negative correlation between illicit drug production and economic development is that engaging in illicit crop cultivation has been, in many parts of the world, a reaction to deteriorating economic conditions. That was the case with the expansion of illicit coca production and illicit opium poppy cultivation in the Andean sub region and in Asia in the 1980s. Such a defensive reaction does not address underlying social tensions and development problems in society. Indeed, it may perpetuate them; eventually, it may itself become the key impediment to development. The emergence of a drug economy can result in the destabilization of the state, the political system, the economy and civil society. b) Destabilization of the state The destabilization of the political system relates to the ability of the illicit drug industry to finance electoral campaigns and corruption, as well as insurgency, terrorism and organized crime. It can distort the investment climate and the basis of sound macroeconomic decision-making. The destabilization of the state is usually the most serious consequence of the existence of a large illicit drug industry in a country. While funds generated by drug trafficking in developing countries may not be large enough to create an economic boom, they are usually more than enough to allow for corruption in the political system. Insurgency groups may discover drug trafficking to be a lucrative source of income; in some countries, such as Afghanistan, Colombia and Myanmar, illicit drug production has been linked to and nourished by civil wars. One of the main consequences of the destabilization of a country is decreasing investment. Once the safety of legitimate investments has been jeopardized, the business climate deteriorates and the prospects for new investment decline. With investment levels declining, economic and social progress and thus long-term

development are compromised. In the countries of the Andean sub region, for example, illicit coca production fell as investment ratios rose, and vice versa.

c) Destabilization of the economy Destabilization of the economy takes on various forms: (a) it undermines macroeconomic decisions to counter the flow of illicit profits, thus creating high interest rates and crowding out legitimate investment; (b) it brings about an overvalued exchange rate as a result of the inflow of illicit profits, diminishing legitimate exports; (c) it promotes illegal business and unfair competition, including obstacles put on Legitimate business; (d) it encourages conspicuous consumption at the expense of long-term investment; (e) it encourages investment in non-productive sectors; and (f) it exacerbates unequal income distribution. d) Destabilization of civil society The illicit drug industry can destabilize not only the state and the economy but civil society as well. This can happen as a result of increased levels of crime (gang wars, kidnapping, extortion); the erosion of social capital; compromised rule of law; the corruption of the elite and/or the political system; gambling and prostitution; drug abuse; and the loss of community cohesion. The main symptom or manifestation of the destabilization of civil society is rising levels of crime, notably violent crime, which has a strong impact on consumption patterns (such as the need to pay for security services) and on individual freedom (notably freedom of movement). Drug-related crime includes acquisitive crime, gang wars, violence in public spaces, extortion and kidnapping. Questions to Consider: 1. Given that the effects of illicit drug production include weakening of the state, its economy and civil society, how can effective strategies be evolved in collaboration with a weakened state to combat the drug menace? 2. How can the spiraling negative effects of illicit drug production be arrested?

2. Drug use and HIV

An estimated 15.9 million people inject drugs, and 3 million of them have been infected with HIV. The coverage and quality of services available to drug users remain low, including in prisons and among people vulnerable to human trafficking. While there has been a focus on drug injection as a mode of HIV transmission, less attention has been paid to the transmission of HIV through other forms of drug abuse. Meth/amphetamine has been linked to sexual risk with multiple groups. These include MSM (men who have sex with men), sex workers, men who purchase sex, heterosexually active people, and occupational groups. Drug use leads to risky sexual behavior, thus increasing chances of HIV transmission. In many countries, the HIV response is insufficiently grounded in evidence and fails to meet international legal obligations to promote, protect and respect human rights. For example, in 40 per cent of the 129 countries submitting reports to UNAIDS there continue to be laws, regulations or policies that interfere with access to and effectiveness of HIV-related services for people who inject drugs. As a result, drug users living with HIV are subjected to a double stigma and often experience discrimination when attempting to access HIV prevention services. Care and support services are frequently unavailable to them and those that are available are generally not tailored to their specific needs, even in instances where programming and funding for HIV programmes have otherwise expanded considerably. There is evidence that drug users are willing to protect themselves, their sexual partners and society at large. HIV transmission through injecting drug use can be effectively prevented by providing a comprehensive package of services to injecting drug users and their injecting or sexual partners. The earlier HIV prevention programmes are implemented, the more effective and cheaper the specific measure will be. 3. Use of Psychotropic Substances to Commit Sexual Crimes The International Narcotics Control Board is warning of an increase in the use of date-rape drugs by criminals to lure their victims. Despite efforts to curb their misuse, the abuse of these so-called date-rape drugs is on the rise. INCB is raising the alarm about new psychoactive substances that are easier to get hold of and under less stringent international controls. The date-rape drug phenomenon, although fairly new, is evolving rapidly, as sexual abusers attempt to circumvent stricter drug controls by using substances not restricted by international drug conventions. Benzodiazepines, which are controlled under the 1971 Convention, have been frequently used by criminals to weaken the resistance of their victims and to exploit their property or body without their consent. Flunitrazepam, a benzodiazepine sold under the brand name Rohypnol, was once so commonly misused for sexual assault that it was called the date-rape drug. However, the adoption of stricter control measures by Governments, in close cooperation with the pharmaceutical industry, has proven effective: nowadays, reports of the misuse of Rohypnol for sexual assault have become rare. At the same time, criminals are turning now to other substancesnotably gamma Hydroxybutyric acid(GHB), a psychotropic substance that was not under

international control until recently, as well as substances that remain outside drug conventions such as ketamine and gamma-Butyrolactone (GBL). Since in many countries most of those drugs are easily available, they frequently fall into criminal hands. What is alarming is the unscrupulous way in which those drugs are used upon unwitting victimsthe drugs, which are usually disguised in food or drinks, are introduced in dosages that are significantly higher than the dosages used for therapeutic purposesa practice which entails serious health risks for the victims. Sexual assault crimes are often committed in public places such as bars, restaurants, nightclubs but also in private surroundings. In view of this serious menace, the international community has come together and shown commitment to address the problem. In March 2009, the Commission on Narcotic Drugs urged all countries of the world to adopt measures to combat the misuse of pharmaceutical products for sexual assault and to enhance public awareness about this serious problem (resolution 52/8). The Commission also invited the pharmaceutical industry to develop formulations with safety features, such as dyes and flavorings, to alert possible victims to the contamination of their drinks, without affecting the bioavailability of the active ingredients in legitimate drugs. Questions to consider: 1) Given that several substances used to commit such crimes lie outside drug control treaties, how can the international community tackle such a problem? 2) Given that several countries do not have laws explicitly criminalizing such offences, what role can the international community play in helping formulate such laws? 4. Non-Medical Use of Prescription Drugs

The non-medical use of prescription drugs controlled under the Conventions is an increasing problem in many countries. In some countries, this is second only to cannabis. This is most notably in North America, but there are reports of significant treatment demand also in Europe, Africa, South Asia and Latin America. Prescription drugs controlled under the Conventions include a wide range of substances: tranquilizers (e.g. benzodiazepines such as diazepam), analgesics/ pain killers (e.g. opioids such as oxycodone), sedatives (e.g. flunitrazepam), antidepressants (e.g. fluoxetine), stimulants (e.g. methylphenidate). Depending on the country and the kind of substance, some groups (such as youth, women, older adults, health care professionals, but also street children and civilians and armed forces in post conflict situations) appear to be particularly at risk. Moreover, the health and social consequences can be as serious as for the use of illicit drugs. In the USA, at least 23% of drug-related emergency department admissions and 20.4% of all single drug-related emergency department deaths are due to the non-

medical use of prescription drugs, and the non-medical use of prescription drugs can lead to dependence, including all its health and social consequences, especially when starting at a very young age. Addressing the non-medical use of prescription drugs needs to carefully take into consideration the need to ensure the availability of these substances (that do have a recognized and much needed medical use), while preventing diversion and misuse. UNODC is developing a discussion paper to assist Member States in addressing the issue of the nonmedical use of prescription drugs, focusing on recommendations on policy and practice. The purpose is to provide the same kind of advice that exists with regard to prevention of the use and the treatment and care of the dependence of illicit drugs. The sources of prescription drugs are different, but the need for prevention and treatment with a view to promoting health is the same. Government authorities, parents, medical doctors, pharmacists, pharmaceutical companies have all important roles to play.

5. Drug Trafficking Drug trafficking is the illegal production and distribution of controlled substances. It includes the money involved in the many phases of the illegal drug business, but it encompasses far more than that. Drug trafficking has far-reaching effects on many aspects of society, from the presence of gangs and gang-related violence to the impact of drug money in poor neighborhoods. Interdiction efforts directed at drug trafficking vary across the globe although, the international nature of drug trafficking prevents any country from combating the trade alone. Organizations such as the United Nations Office for Drug Control and Crime Prevention are working to maintain and assist international interdiction activities and encourage countries to join international drug control efforts. The US government has officially called for a 'War against Drugs' and consequently, the nation plays a leading role in the push for aggressive counter-drug tactics across the globe. Their activities focus on interdiction and eradication operations in drug transit zones and source countries, and also urge other countries to adopt 'drug war' policies. Despite these efforts, it is estimated by the United Nations that only 10-15 per cent of heroin and 30 per cent of cocaine is intercepted worldwide. At least 70 per cent of international drug shipments need to be intercepted to substantially reduce the industry. Reports suggest that there has been an increase in successful interceptions however; the drug market continues to produce the same, or even higher, quantities of illicit drugs. Developed efforts of drug control authorities in some countries have merely moved drug trafficking operations to weaker jurisdictions and forced greater organizational sophistication. Important Resources:

1. Joint United Nations Programme on HIV/AIDS, 2006 Report on the Global AIDS Epidemic: A UNAIDS 10th Anniversary Special Edition (Geneva, 2006). 2. WHO, UNODC, UNAIDS Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users (World Health Organization, Geneva, 2009)

C) Bloc Positions The United States and Other Industrialized Nations The United States has been adamant in its Drug War, strictly enforcing the antidrug policy, attacking the cultivation, consumption, trafficking, or resale of narcotic drugs. According to the Office of National Drug Control Policy, the US supports fully crop eradication and interdiction by local governmental forces .The United States has become increasingly active in drug eradication policy as a result of the War on Terror. The task of drug elimination has now become increasingly focused on the containment of drug trade, a major source of income for terrorist organizations worldwide (Perl 1). Without enough emphasis on more cost-effective and long-term solutions such as alternative development, the US government is inefficiently controlling drug production. The US and other allied industrialized nations argue that their main priorities are to reduce foreign drug production at its source, encourage interdiction and enforcement activities in the disruption of supply lines, reduce drug demand, and utilize economic disincentives for international drug trafficking. These efforts have proven ineffectual, as the availability of illegal narcotics within the US remain the same. The immense flows of trade across American borders, combined with the small quantities of drugs necessary to reap significant profits, make the successfulness of interdiction efforts low. As seen in its international diplomatic efforts, the US has made their seriousness of its drug enforcement policy overtly clear. Southeast Asia and the Pacific Within Southeast Asia, the territory at which Laos, Myanmar, and Thailand meet is known as the Golden Triangle, a region first in drug production only after Afghanistan. In spite of the overwhelming production of illicit narcotics and opiates within the region, penalties for drug use are extremely high. For first-time drug users, a penalty of three years of jail time exists; repeat offenses are more strictly

punishable and can even result in death. Laos, Myanmar, and Thailand have been involved with substantial sub-regional cooperation toward drug control and have established a significant relationship with narcotic control bodies in China. The majority of the bloc as a whole has agreed to the terms of several of the significant international conventions that work to restrict narcotic drugs. This includes the UNDCP regional Center Geographic coverage, the 1961 convention, the 1971 convention, and the 1988 convention (Regional Drug 21). Several countries have taken drug matters into consideration individually by implementing national institutions for drug control. These include: Cambodia: The National Authority Combating Drugs (NACD) China: The National Narcotics Control Commission (NNCC) Indonesia: National Narcotics Coordinating Board (BKNN) Laos: Lao Commission for Drug Control and Supervision (LNCD) Malaysia: The National Narcotics Agency Myanmar: The Central Committee for Drug Abuse Control (CCDAC) Philippines: The National Drug Law Enforcement and Prevention Coordinating Centre Thailand: The Office of the Narcotics Control Board (ONCB) Vietnam: The Standing Office for Drug Control (SODC) The Pacific: The Pacific Forum Secretariat The problem overall has been viewed by the bloc as a priority issue, one that needs a significant amount of external international assistance in the form of enforcement support and financial aid, as regional budget constraints can be hindering. Europe The European bloc, through the European Union, has provided substantial support for their most current drug policy, the EU Drugs Strategy. The main focus of the Strategy is to further demand and supply reduction by means of specific goals and objectives (The Action Plan 1). The EU Drugs Strategy, effective until 2012, aims to limit drug use, new recruitment to drug use, incidences of drug-related health problems, the availability of drugs, the number of drug-related crimes, money laundering, the illicit trafficking of precursors, and the number of drug-related deaths. Current EU member nations have made significant progress in complementing action taken by the EU as a whole. Nations have implemented local preventative techniques, intense cross border trafficking prevention, and coordinating mechanisms to contribute to the effectiveness of the European Union as a whole (EU Drugs Action 2). The blocs overall main priorities are to create a plan that combines prevention with assistance, deviating from a policy of strict noncompliance with the international drug scene. In a recent movement toward transnational homogeneity within Europe, multilaterally is favored over unilateral action by most European nations. Latin America Within Latin America, there has been a great movement of legalization of narcotic drugs. Although most governments, such as Colombia, comply with US and UN based drug eradication, there has been a significant portion of the Latin American population emphasizing strongly their want of drug legalization. In Bolivia, the coca

plant is seen as traditional and sacred; Bolivians believe that the international drug problem is attributable to an uncontrolled demand, rather than supply of drugs (Latin America and 2). Latin Americans have experienced increasing resentment toward eradication movements, and they are beginning to fight for a significant aspect of their income. In February of 2003, The First American Legalization Summit took place in Mexico, at which activists, legislators, and advocates from throughout Latin America, the US, and Europe focused on the legalization of drugs and decriminalization of drug production (Out From the 1). An increased amount of anti-drug control sentiment has continued to progress in Latin America, creating a new obstacle in the fight for drug control.

D) Resources Important websites: www.un.org/ www2.ohchr.org/english/bodies/hrcouncil/ www.unodc.org/ www.incb.org/

Important Reports/documents: (Delegates are strongly advised to be well versed with the contents of the following reports/documents) 1. UNODC Discussion Paper titled From coercion to cohesion- Treating drug dependence through health care, not punishment 2. Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug ProblemVienna, 2009 (Suggested Reading) 1. INCB Reports: 2005: Alternative development and legitimate livelihoods 2009: Primary prevention of drug abus

2. Crime and instability- Case studies of transnational threats