Opioid Epidemic Provides an Unexpected Benefit? International Law Inspires a Shift from Punitive to Curative Responses to Addiction
LEONARD MUKOSI* ∙ OCTOBER 20, 2019 ∙ COMMENTARY
Opioid misuse, addiction, and overdoses are becoming serious public health problems globally. According to the 2019 World Drug Report, in 2017 alone, the use of opioids accounted for 110,000 (66%) of the 167,000 deaths attributed to drug use disorders.[1] Commendably, however, the devastating effect of the opioid crisis has triggered a long-awaited response to the problem of drug abuse and addiction in general. A curative approach is slowly emerging, replacing the traditional punitive responses to addiction.[2]
The Commission on Narcotic Drugs (CND) is currently the main drug-policy-making organ within the United Nations.[3] The CND is one of the functional commissions of the United Nations Economic and Social Council (ECOSOC). One of the main functions of the CND is negotiating and adopting resolutions.[4] The ECOSOC then recommends the resolutions passed by countries at the CND to the United Nations General Assembly for adoption. These resolutions usually shape and represent the world’s stance on the drug problem.[5]
A review of past resolutions adopted by the General Assembly unveils the bias toward punitive responses to addiction. In 1981, Bolivia addressed a request to the United Nations asking to include the item “International campaign against drug trafficking” in the United Nations General Assembly.[6] The issue became one of the General Assembly’s main agenda items in subsequent years, stimulating the longstanding focus on criminal justice rather than healthcare responses to the problem of drug abuse globally.[7] The world’s main focus then was to punish drug users and traffickers as exemplified by the United States’ harsh stance, which dates back to the Harrison Narcotics Act of 1914,[8] and later, the war on drugs.[9]
While addressing the 61st Session of the CND in 2018, United Nations Secretary General António Guterres highlighted the need to move toward public health responses to addiction.[10] He said, “With the UN General Assembly special session consensus as our blueprint, we can promote efforts to stop organized crime while protecting human rights, enabling development and ensuring rights-based treatment and support.”[11] Accordingly, countries at the 61st Session drafted health-based resolutions to address the problem of drug addiction and pledged their commitment to implementing these resolutions domestically.
The United States of America and the United Kingdom drafted a joint resolution stating their determination to strengthening national and international action to address the challenges posed by the non-medical use of synthetic opioids, including their adverse health consequences.[12] Comparably, Canada and Uruguay mentioned in their draft resolution that they are “concerned by the effect of stigmatization on the availability of healthcare and social services for people who use opioid drugs.”[13]
At the recommendation of the ECOSOC, the General Assembly adopted these resolutions and encouraged countries to adopt comprehensive public health approaches to reduce drug abuse.[14]
Certainly, this signals the dawn of a new trend that is also noticeable at the domestic level. On October 24, 2018, President Trump signed into law the Treatment for Patients and Communities Act,[15] which aims to address the opioid crisis through the public health system. The Act requires state Medicaid programs to cover medication-assisted treatment (MAT), including all FDA-approved drugs, counseling services, and behavioral therapy, among other health-based solutions.[16]
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*J.S.D. Candidate, University of Arizona James E. Rogers College of Law, 2021; LL.M., Michigan State University College of Law, 2018; LL.B., Rhodes University, 2016; B.Soc.Sc., Rhodes University, 2014.
[1] Institute for Health Metrics and Evaluation, “Global Burden of Disease Study”, Global Health Data Exchange (2017).
[2] Amanda Kay, The Agony of Ecstasy: Reconsidering the Punitive Approach to United States Drug Policy, 29 Fordham Urb. L.J. 2133-38 (2002).
[3] United Nations Office of Drugs and Crime https://www.unodc.org/unodc/commissions/CND/ (last visited on Oct. 12, 2019).
[4] Id.
[5] See id.
[6] Giovanni Molano, A View from the South: The Global Creation of the War on Drugs, 39 (3) Contexto Inernacional, 633-53 (2017).
[7] G.A. Res. 41/127 (Dec. 4, 1986), see also G.A. Res. 42/113 (Dec. 7, 1987), and G.A. Res. 43/122 (Dec. 8, 1988).
[8] Ch. 1, 38 Stat. 785. Under the act, physicians who were prescribing drugs to addicts on “maintenance” programs were harshly punished.
[9] German Lopez, The War on Drugs Explained, Vox (May 8, 2016, 1:21 EDT), https://www.vox.com/2016/5/8/18089368/war-on-drugs-marijuana-cocaine-heroin-meth.
[10] United Nations Office of Drugs and Crime, supra note 3.
[11] Id.
[12] U.N. ECOSC Res. 61/8 (Mar. 2018). The USA and Britain were also joined by Belarus, Japan, and Northern Ireland in adopting this resolution.
[13] U.N. ECOSOC Res.7/2018 (Feb. 13, 2018).
[14] G.A. Res. 73/591(Jan. 22, 2019).
[15] H.R. 6, Pub. L. 115–271.
[16] Id. at Sec. 1006 (B).
Tags: Public Health, Drug Addiction, Opioids, War on Drugs