Why are drugs a health and human rights issue?
Many governments have criminalized the use of drugs, as well as their possession, production, and distribution. Human Rights Watch has documented how this approach to drug policy has had devastating human rights consequences: undermining the rights to health and privacy; serving as an excuse for grossly disproportionate punishment, torture, and extrajudicial killings; and fueling the operations of organized criminal groups that commit abuses, corrupt authorities, and undermine the rule of law. At the same time, excessively strict drug-control regulations has deprived millions of patients worldwide of pain relief medicines.
What are the most important problems?
According to the United Nations, scientific evidence supports the need for a shift in the global approach to drug use. A report published by UNAIDS in 2016 found that the vast majority of the 246 million people who use drugs have been criminalized by national legislation and have been marginalized by society. People who use drugs have been traumatized by violence, imprisoned for possession of small quantities of drugs for personal use or coerced to undergo drug dependence treatment. Drug users have been put in detention without charge, in lieu of receiving adequate treatment. They are often forced to hard labour. Detention in lieu of adequate treatment is a violation of the right to health. Hundreds of thousands have been incarcerated in compulsory detention centres, including more than 455,000 in seven Asian countries.
Women who use drugs have been forced to undergo sterilization or abortions, separated from their children and denied public housing and other benefits. People who use drugs, especially those who inject drugs, have been isolated and often denied the means to protect themselves from HIV, hepatitis C, tuberculosis and other infectious diseases. Among the estimated 12 million people who inject drugs globally, 1 in 10 is living with HIV.
HIV and hepatitis – As mentioned above, drug criminalization policies and their related aggressive law enforcement practices violate the human rights of people who use drugs and negatively affect their overall physical and mental health. For example, the Global Commission on Drug Policy has found that these criminalization policies result in insurmountable barriers to HIV prevention and treatment. Unfortunately, the Commission also confirmed that, despite ample evidence showing that treatment of HIV infection among people who use drugs dramatically reduces the total number of new infections, the public health implications of HIV treatment disruptions resulting from drug law enforcement tactics have not been appropriately recognized as a major impediment to efforts to control the global HIV/AIDS pandemic.
Similarly, in 2013, the Commission released a report describing how drug criminalization policies violate the human rights of people who use drugs and perpetuate the spread of hepatitis C. In contrast, the UN has confirmed that countries that have taken a human rights-based approach to drug laws and policies have fewer new HIV infections and improved health outcomes overall than countries that criminalize people who use drugs. Human rights-based policies also deliver broader social benefits, such as lower levels of drug-related crime and reduced pressure on health-care and criminal justice systems.
What can health workers and their professional organizations do?
Although people who use drugs have increased health-care needs, they have limited access to health services. As a result, health workers can provide assistance in a variety of ways. Depending on a health worker’s expertise, there may be opportunities to assist on the clinical side. For example, physicians and nurses often assist people who use drugs in addiction clinics, where they prescribe medication and supervise detox programmes. Social workers can also provide a wide range of assistance including but not limited to conducting psychosocial assessments, collaborating with a clinical treatment team, conducting ongoing counseling with a patient and significant others, and working with people who use drugs to establish positive support networks.
Some of the other ways health workers can assist is by:
- Training elected officials and law enforcement on human rights, addiction, and effective disease prevention;
- Providing at-risk youth and adults with emotional support and assistance in accessing education, employment and training services;
- Advocating on behalf of people who use drugs who are in need of healthcare, housing or other support;
- Holding their government accountable for preventing drug users from receiving adequate health care and put them in detention instead.
- Volunteering as outreach workers to help people who use drugs with their immediate needs, such as crisis intervention and temporary shelter;
- Volunteering at drop-in centres where people who use drugs can go when they need information and support services; and
- Providing needle exchange and other harm reduction services.
This page was written by Tara Ornstein in February 2018.
 Human Rights Watch. Drugs and Human Rights. New York, 2018.
 UNAIDS. Do No Harm. Geneva, 2016.
 Global Commission on Drug Policy. The War on Drugs and HIV/AIDS: How Criminalization of Drug Use Fuels the Global Pandemic. Geneva, 2012.
 Global Commission on Drug Policy. The Negative Impact of the War on Drugs: The Hidden Hepatitis C Epidemic. Geneva, 2013.