By Marie Nougier (IDPC) and Adrià Cots Fernández (IDPC)

For centuries, criminal laws, justice systems, and prisons have been designed for, and by, men. The 2010 United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders, also known as the ‘Bangkok Rules’, break away from this history by establishing the first set of international human rights standards that focus on the specific needs and experiences of women deprived of liberty.

Ten years after the adoption of the Bangkok Rules by the 193 countries represented at the UN General Assembly, states across the world have largely failed to implement them, while the number of women in prison has continued to raise dramatically. By 2020, an estimated 741,000 women were incarcerated worldwide, compared to 636,000 in 2010. The global female prison population is estimated to have increased by about 59% from 2000 to 2020.

This worrying trend has been fuelled by the harshly punitive drug laws adopted at the end of the 20th century. In many countries in Asia and Latin America, drug offences are the main cause for the incarceration of women. In most cases, women are detained for carrying out low-level drug activities, such as transporting drugs, that are characterised by high risk, a high degree of replaceability within illegal drug organisations, and very little financial reward.

Although theoretically ‘gender-blind’, punitive drug policies such as the disproportionate use of pretrial detention, mandatory minimum prison sentences, and the dearth of harm reduction and evidence-based treatment in prisons, have impacted women disproportionately. They have also ignored the causes for women’s involvement in illegal drug activities, which include the intersection of poverty and caretaking responsibilities, and coercion or influence at hands of a male relative or partner. In other words, they have undermined the application of the Bangkok Rules.

For advocates across the world, the 10-year anniversary of the Bangkok Rules is an opportunity to remind states that 

gender equality policies, criminal justice rights and drug laws are not isolated from each other

. If states want to implement a genuine agenda for gender equality, they need to review the laws and policies that undermine it – including drug legislation.

This briefing paper provides analyses the concrete ways in which punitive drug legislation has impacted upon the achievement of the Bangkok Rules, and offers several recommendations on how to translate the commitments set in the Bangkok Rules into drug policy. These include the following urgent recommendations:

Address prison overcrowding by immediately releasing all women incarcerated for minor or non-violent drug offences, including but not limited to drug use and possession for personal use, and non-violent drug supply offences committed by women in situations of vulnerability, and ensure adequate support to transition into the community.

In the context of COVID-19, it is especially urgent to release women with health risks, and women in situation of vulnerability, such as older women, disabled women, pregnant women, women with children, and women responsible for other dependants.

Urgently amend existing laws and policies to ensure that women charged with, indicted for, or convicted of minor or non-violent drug offences are eligible for diversionary measures and alternatives to incarceration and punishment.

Ensure that women who remain in prison during the pandemic have access to strictly voluntary evidence-informed, rights-based, gender-sensitive drug services, including drug dependence treatment, harm reduction and additional support services focusing on addressing past histories of trauma, gender-based violence and mental health.

Punitive drug laws: 10 years undermining the Bangkok Rules

The expected escalation of the Russian government’s crackdown of civil society poses a fundamental challenge. The new amendments to the so-called Foreign Agents Law (FA Law) have created new threats and vulnerabilities for civil society organisations (CSOs) as well as active citizens. Since its introduction in 2012, this law has targeted independent Russian CSOs, including human rights organisations and those providing HIV and social support services. On December 30, 2020, the President of the Russian Federation signed the amendments to the FA Law which broadened its enforcement to include human rights defenders, journalists, and political activists in their personal capacity. In the past eight years, the government has sanctioned approximately 180 CSOs under this law. The grounds for being recognised as a "foreign agent" have been extended. In addition to the previous two criteria (being involved in political activities while receiving money from abroad), they now include expressing opinions regarding state policies, if the Russian government deems these opinions to be in the interest of a foreign entity. Under the amended law, the individuals designated as “foreign agents” will face penalties of up to five years in prison for failing to register and report on their activities. The new amendments signal a renewed crackdown on independent Russian CSOs and politically active citizenry, likely causing a further shrinking of space for Russia’s civil society and increased self-censorship. The government’s attacks on civil society have already reverberated through the regions and have intensified fear of prosecution. Nowadays, four lists of «foreign agents» exist: 1) non-commercial organisations; 2) the media; 3) unregistered public organisations; and, 4) individuals.

While the social and economic situation for a vast majority of Russian citizens has been aggravated by the COVID-19 pandemic, the Russian government will likely use the new amendments to legitimise its further crackdown on civil society. The financial shortfall has already affected charities in Russia, and will have a broader effect on those small-sized CSOs who struggle to retain human resources. Access to resources for such smaller scale CSOs has also been affected by the enforcement of the Law on Undesirable Organisations, which bars select foreign-based organisations from operating in Russia and criminalises cooperation between them and Russian CSOs. To-date, thirty international and foreign-based organisations have been added to the list of undesirable organisations.

Russia: Submission to the Special Rapporteur on the rights to freedom of peaceful assembly and of association

By The Federal Ministry for Economic Cooperation and Development

The illegal cultivation of the drug crops coca and opium poppy has increased sharply over the past ten years. In 2019, coca cultivation reached an all-time high of 244,200 hectares. Furthermore, the production of the coca and opium-poppy based drugs cocaine and heroin is continuously at a high level. It is estimated that 1,723 tonnes of cocaine were produced across the globe in 2018, and 472–722 tonnes of heroin in 2019. In the European Union (EU) and also in Germany, more cocaine was seized than ever before. In 2018, an estimated 269 million people consumed illegal drugs, of whom 30 million people used opiates and 19 million cocaine.

The main cultivation areas of opium poppy are mainly located in remote rural areas of Afghanistan, Myanmar, Mexico and Laos. There are also smaller areas in Colombia and Guatemala. Coca cultivation is concentrated in the Andean countries of Bolivia, Colombia and Peru.

Illicit drug crop cultivation, drug trade and consumption are global phenomena. However, the harmful consequences of the drug economy hit the countries of the Global South particularly hard and have a deep impact on the social structures. According to data from 2017-2018, between 605,000 and 970,000 households worldwide illegally cultivate coca bush and opium poppy. In some regions of West Africa, South-East Asia and Latin America, entire political systems are influenced by drug cartels and thus limited in its ability to act.

Alternative development: Sustainable change through development-oriented drug policy

There is an increasing tendency to get service users, such as Drug Users (DU’s) involved in health services and health policies. Participation is seen as an indispensible ingredient for good and effective policymaking and there exist numerous best practice examples of peer involvement in the field of health promotion and prevention. Health policies and health interventions are considered to be more effective and supported, when all relevant parties and communities (including civil society and the final target group) are being involved equally. In addition, policy makers and professionals realise that it is no longer appropriate to talk about and not with the final target group. All kind of communities and also DU’s demand their rights: they want to be heard and they want to be taken serious.

There are numerous ways and forms of participation and also the purpose varies from case to case. One could think of information sharing and consultation or focus on empowerment and joint decision-making. Saying this, it can be assumed, that participation is not only a tool and a method, but also a process and a principle. Yet there are numerous drawbacks which jeopardize the process and make it difficult to respond appropriately. DU’s are often poorly represented in service provision and decision making, although there is evidence that their knowledge and expertise is important and most useful for the development of tailored responses and policies.

‘Nothing about us, without us’ - Participation and involvement of drug users in health services and policy making 

By Zara Snapp Jorge and Herrera Valderrábano

Historically, the poppy plant has had multiple uses including as a food product and with medical uses in pain relief; today it is most commonly known as the plant from which heroin is derived. The United Nations international drug control regime currently only allows legal poppy production for medical use in 19 countries. Although Mexico is the third largest illegal poppy producer in the world, no Latin American country is currently allowed to legally produce poppies.

Meanwhile, the United States and Canada are experiencing an overdose crisis due in large part to the adulteration and substitution of heroin with fentanyl and its analogues, while the price of opium gum has dropped 80% in the last two years in poppy producing areas of Mexico. The prohibition of opium has wide ranging health and development impacts that bring up a moral imperative regarding the safe supply of diverse opium-based products –including opium gum and heroin– that urgently need to be explored and addressed. Opium gum can be used orally or smoked, reducing riskier modes of administration and possible fatal overdoses.

Tracing a path for opium gum from Mexico as a safe supply harm reduction measure for Canada

Women who use drugs are exposed to higher rates of violence than other women. This violence includes, (but is not limited to) rape, sexual harassment, extortion, loss of child custody, imprisonment for mere personal possession, extra judicial killing, capital punishment and penalisation for drug use in pregnancy. Prohibition either directly causes or greatly exacerbates conditions for all of these violations. Gender-based violence cannot be eliminated if those most affected are not directly and meaningfully involved at all levels in relevant policy and programming.

Women who use drugs are boldly stepping out to take their place in the women’s movement and efforts to stop gender-based violence. Collectively we and our allies call for governments to end the gendered, failed and murderous policy of drug prohibition.

The elimination of violence against women who use drugs (EVAWUD) - 2020 campaign report

During the lockdown that followed the arrival of COVID 19, many local drug services closed their doors to clients, contacting them instead by internet or telephone. Alongside this, People Who Use Drugs who had attended pharmacies to collect their prescriptions were permitted to cut visits to the pharmacy and being observed by the pharmacist or staff, they visited on a weekly or two-weekly basis. The reduction in attendance at the pharmacy has proved to be useful for drug users, offering a more humane, dignified and therapeutic arrangement.

This fits in with the overall goals of good drug Opioid Substitution Therapy, which should involve a therapeutic partnership between drugs services and those who use them. Therapeutic arrangements should be negotiated and agreed upon, not forced upon clients by the drug service.

Senior policy makers and managers and professional leaders in OST have acknowledged that people on OST in the UK have responded overwhelmingly with responsibility to the opportunity of take-home doses. EuroNPUD has been assured that OST services will focus on reaching the 50% of people with opioid dependence who are not currently accessing OST rather than reintroducing take home dispensing.

Take-home opiate substitute therapies (OST) - EuroNPUD advocacy brief

Medications like buprenorphine, methadone, and morphine bind to the opioid receptors and stop the withdrawal symptoms and cravings. These medications are known as Opioid Substitution Therapies or OST for short. If you have developed a dependence on short-acting opioids, such as heroin, you will get sick about 6-8 hours after you last used. However, OST is longacting and buprenorphine and methadone both work for at least 24 hours. With the right dose, someone with opioid dependence will usually only need to take OST once a day and with the new long acting depot buprenorphine only once per week or per month.

OST is a life-saving medication that takes you away from the challenges of raising money and the risk of going into withdrawals. It also reduces your risk from viruses like HIV and hepatitis and your vulnerability to opioid overdose and police arrest.

We're in this together - All about treatment for opioid dependence from people who have lived it - Client guide

In their Global State of Harm Reduction: 2019 updates, HRI note that the spread of harm reduction services is still stalling globally in continuation of a trend observed since 2012. The 2018 Global State of Harm Reduction 2018 briefing, highlights that although women are estimated to account for one third people who use drugs globally and are consistently reported to have less access to harm reduction services and to be at higher risk of HIV and hepatitis C infection, robust data on this subject is scarce, and research on drug use and related health issues rarely produces information about women.

While tools exist to enable harm reduction services to institute a gender lens and gender mainstreaming in their programming in order to improve relevance and reach to women who use drugs, services that have introduced such approaches are thin on the ground. Where they do exist, there is not necessarily scope to document and promote experience. In order to leverage greater accountability from governments that have endorsed UN guidelines and resolutions around provision of services for women who use drugs, it is important to document and promote such services where they do exist, so that models of replication can be resources and established at other harm reduction programmes, while pressure builds to reverse the stalling of actions that improve respectful access to health for women who use drugs. With this in mind, WHRIN undertook a survey, in order to attempt a ‘mapping’ of women friendly services around the world.

Mapping harm reduction services for women who use drugs - WHRIN regional survey results

By Gabriel Moshenska & Shaun Shelly - Archaeology International/UCL Press,

This article explores the values and challenges of an archaeological approach to illicit drug use, based on the study of discarded drug paraphernalia. It builds upon recent archaeological studies of homeless people, refugees and other marginalised communities that have used participative methods to challenge societal stigma and erasure. Following a critique of previous archaeological studies of drug use, the core of the article is a detailed analysis of an assemblage of drug paraphernalia in Oxford, UK. In interpreting this assemblage and its material and emotional contexts we draw on our respective contemporary archaeological and drug user activist experience and expertise. By providing a critical overview of previous studies and a detailed case study, this article aims to provide a practical and conceptual foundation for future archaeological studies of illicit drug use.

Notes for an archaeology of discarded drug paraphernalia

By Ernst Wisse et al. / International Journal of Drug Policy

COVID-19 holds the world in a tight grip. In these unprecedented times, health and health-system capacities have been on the top of the global agenda for several months. Many countries have rolled out far-reaching prevention measure such as physical distancing and ‘lock- downs’ to prevent (further) overwhelming of health system capacities.

In many contexts, people who use drugs are a vulnera- ble population, prone to poor access to health services com- pounded by criminalization, and stigmatisation in health-care settings.( UNAIDS, 2019 ) , ( Van Boekel, Brouwers, Van Weeghel & Garretsen, 2013 ) This is illustrated in poor health outcomes and persisting high risk of infectious diseases. For instance, people who inject drugs are left behind in the progress of the global HIV re- sponse with less than 1% living in a country with high level of critical prevention services, such as access to sterile syringes and low-threshold opioid treatment programmes or opioid agonist therapy (OAT).

Marginalised and criminalised communities have greater challenges accessing health services.( UNAIDS, 2019 ) Consequently, a health sys- tem under too much pressure would likely disproportionally impact peo- ple with already established barriers, such as people who use drugs. Looking back at the conceptual building block framework, the notion of equity has been explicitly integrated in the goals of improved health outcome. This underlines that perhaps health systems have a tendency to ‘serve the mass’, and additional attention is needed to ensure equi- table access for all, including criminalised and marginalised communities such as people who use drugs.

COVID-19 and people who use drugs; seizing opportunity in times of chaos

By Correlation European Harm Reduction Network

Harm reduction centres are often the only point of access to health and social services for many PWUD. Preliminary research on the effects of the COVID-19 pandemic on drug services and PWUD has noted decreases in available harm reduction services.

European harm reduction services needed to be innovative and adapt very rapidly in response to the fast-changing landscape of the pandemic and its associated national control measures.

Frontline harm reduction workers play a crucial role in public health response during COVID-19 and are instrumental in implementing these rapid-scale changes required to keep vital services operational.

Their experiences during the pandemic provide critical data to understanding the effect of the pandemic on the vulnerable population of PWUD and the health services they depend on.

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