Shameful Pain
The International Narcotics Control Board has delivered its annual report. At the cover of the report, we are told to observe release date: "Not to be published or broadcast before Wednesday, 23 February 2000, 0900 hours (GMT)." It must be an important report. It is. It is a report from, so to say, the "Central committee", those deciding the Global Drug policy. It is a report on what they think about the world situation, what they have done last year, and what they think ought to be done next.
It is a depressing report due to its complete absence of imaginative thinking. And it is a report revealing shameful conditions.
I. A picture of failure
First to the lack of innovative thinking. A major element in the report is that most has gone wrong last year. The situation is becoming worse and worse. In Europe, under the headline Major developments (p.54)
The availability of cannabis in Europe has increased considerably.
Cocaine seizures throughout Europe have increased. ....surveys undertaken in secondary schools in western Europe have revealed an upward trend in cocaine abuse, brought about, in part, by lower prices.
…
The abuse of synthetic drugs, in particular amphetamine and amphetamine-type stimulants, has risen.
…
"The board is satisfied that the number of heroin abusers is declining in most western European countries, however, heroin abuse has become a growing problem in Eastern Europe.
…
A particularly alarming trend has been the rapid spread of HIV infection in some eastern European countries. The number of HIV-infected persons in Latvia increased sevenfold between 1997 and 1998. There was a 12-fold increase in the number of HIV-infected person in the Moscow area in the first half of 1999 compared with the same period in 1998. The rapid spread of HIV infection is largely attributable to the infection spreading among intravenous drug users.
From Afghanistan (p.49) we learn that
the large-scale illicit cultivation of opium poppy has continued to spread to areas in the country which were previously not affected by it. It is estimated that, due to favourable weather conditions, the production of opium in 1999 increased sharply compared with the 1998 figure, to a record level of about 4,600 tons.
From South America (p.39) we learn that the Board notes with concern that:
the availability of coca leaf for the illicit manufacture of cocaine hydrochloride in the region as a whole and the supply of cocaine hydrochloride to illicit markets in Europe and North America do not seen to have been significantly reduced.
Central America and the Caribbean are not better off. Here the major development is described (p.32) as one where the region is
...increasingly being used to trans-ship substantial quantities of cocaine and cannabis from countries in South America to the United States and to countries in Europe. The transit traffic has increased the availability of cocaine in Central America and the Caribbean and cocaine abuse i spreading in a number of countries in the region.
North America (p.36) seems to create less concern in the Commission, except for the increasingly popularity of hydroponically grown cannabis with a high THC content. The Board mention (p.37) that the intensified drug law enforcement activities have resulted in a significant increase in the prison population, but does not give any evaluation of it.
II. More of the same
On the basis of all this misery described above, one might have thought that the Commission would have pulled all this information together and said; Failure, failure, failure! May be we are on wrong path? May be we must reconsider? May be we must change our major policy?
But that is not what they are doing. Their answer is; Give us more of the same. They send delegation in East and West and North and South to get all countries on this Globe to sharpen their measures, particularly penal law measures. They note with satisfaction the adoption of new, or the strengthening of existing drug control legislation in Bulgaria, Hungary and Latvia. They welcome that Croatia passed a law removing legal impediments to undercover operations, the use of controlled delivery and the collection of evidence. They are very unhappy with Portugal where they have approved a law stipulating that drug users will face fines rather than jail sentences. They note, without comments, that the Russian federation and Slovakia have adopted new (more severe, N.C.) drug control strategies, and they can also tell us that Russia has established an inter-ministerial centre for the co-ordination of action against illicit drug trafficking. Considering Human Right problems in West-Asia, it is slightly surprising to find these comments from the Board (p.50):
The Board notes with appreciation the agreements between Tajikistan and Uzbekistan, between the Islamic Republic of Iran and Kazakhstan and between UNDCP and Armenia, Georgia and the Islamic Republic of Iran and the declaration of the heads of State of China, Kazakhstan, Kyrgyzstan, the Russian Federation and Tajikistan pledging mutual cooperation in fighting, inter alia, drug trafficking.
They go to all sorts of regimes to get them in line, force them into more severe measures. More punishment and pain against drugs. They can not know what they are doing. Russia has one million prisoners. Among these are 90.000 with TB, and among these again 30.000 with the multi-resistant type. Their conditions of despair are described in the book "Sentenced to die". I visited the Russian Duma (their Parliament) just a few months ago. They had learned from the West. One drug addict would recruit 10 new addicts was the opinion, so, there was an urgent need to arrest drug-users. I have been in Russian prisons where there is so little room that some prisoners have to stand until it is their turn to sit down, or – with two others in the same bed – make an attempt to sleep. More prisoners are due, inspired or forced by the International Narcotics Control Board. And of course; No mention is given to the broader political problems of US. intervention in Latin America. Motivated as being part of the Drug-War, this means in effect providing support to military forces and political regimes with very dubious political reputation.
The US-prison explosion is also well known to most of us. The US passed the two million mark in prison population the very same week the Control Board released their report. They are now ahead of Russia in number of prisoners per 100.000 inhabitants. The drug laws are the major instruments behind the growth.
The International Narcotics Control Board is one of the major forces behind a policy that destruct important elements of the civil society. They do it as a matter of course, as if there were not other alternatives. And they have done it like this for years. Kettil Bruun, Ingemar Rexed and Pan Lyn described it already in the book "The Gentlemen’s Club". Robin Room and Angela Paglia document the same:
In the same vein, the Commission’s Report on the 1997 sessions noted that "despite the rising trend in seizure of drugs, the world-wide drug problem had shown no significant decline during the past year". Other voices within the system are in consensus: "year after year, the situation is worse", as the delegation from Greece put it in the CND general debate in 1994. Summing up the situation in the l195 general debate, the Interpol representative noted that "I am reminded of the film title, Same Time, Next Year."
III. The utmost of brutality
There is one new element in the report for 1999. The Control Board deserves credit for taking up the matter, but deep distrust for the way they handle it. It has to do with pain. Sick people in severe pain do not get the necessary drugs to alleviate pain and suffering. The Board finds it deplorable, and states (p.4-5):
In the regions where the majority of the world population lives, actual availability of medicines is determined by economic factors rather than by real medical needs.
...
only about 10-13 per cent of patients suffering from severe cancer-related pain may be receiving adequate treatment, even in many technologically advanced countries. The rate is much lower in developing countries. The Board has requested Governments to pay more attention to this particular problem and to identify and deal with the factors that cause inadequate availability of opioids for medical purposes.
It is kind of the Board to request Governments to pay more attention to this problem. But the crux of the matter is of course the prohibitive policy carried out by the Board. To prevent what is seen as illegal use, all sorts of hindrances have been established, hindrances that also prevent sick people, dying people, from getting help against their pain. People in rich countries can get their morphine. And rich people in poor countries can get it. But not the poor. The Board tells (p.4-5):
"The 10 largest consumer countries accounted for as much as 80 per cent of analgesic morphine consumption. The average per capita consumption of morphine in 1998 in the 10 countries with the highest morphine consumption levels was 31 grams per 1,000 inhabitants. In the 10 countries with the next highest consumption levels, the corresponding figure was 16 grams per 1,000 inhabitants. In the next 60 countries, with a total morphine consumption of more than 1 kg, it was only 2 grams per 1,000 inhabitants. In the remaining 120 countries, there was little or no opioid consumption. Several African countries reported no morphine consumption.
The Board is also aware that the control system is behind much of this cathastrophy:
The impediments to opioid availability that are frequently reported by government authorities are:
The most frequently mentioned causes of inadequate opioid availability are restrictive regulations, cumbersome administrative procedures, concerns about diversion and the consequences of inadvertent errors, concerns about iatrogenic addiction, and inadequate or insufficient training of health personnel. The removal of these impediments should be first of all the responsibility of the concerned Governments and that of the medical profession.
I read this in a mixed feeling of despair and anger. We, the rich countries, are exempt from pain. We can die without severe pain. Our doctors can give us sufficient morphine. Our health-systems have money enough to buy us relief from physical suffering. Our governments are organised enough to apply to the Board for permission to import the necessary quantities, and if a sudden extraordinary need should appear, they would even know how to get an extra amount, immediately, and in complete co-operation with the Control Board.
And then, in contrast, if we happen to live in Africa: Great pain, no drugs. Opium might have been exported as raw material to the industrialised countries. But lack of money makes it impossible to buy it back in the form of legal medicine. Many of these countries are dependent on international relief organisations for medicine. Here, we might think, here comes the pain relief. But that is not the case. When the international organisations send off their medicine-kits, they have to remove the pain-relievers according to the rules of the international control system. Such substances might lead to abuse in these countries so far away.
People die in pain, surrounded by poppy-flowers. One might of course hope that local people act according to local traditions and produce their drugs without any concern for any Control Boards in Vienna. But I do not feel confident that this is the case. And I see no encouragement from the Board for such actions
The fact that deadly sick people are left to die in severe pain in the midst of those plants that supply the industrialised countries with pain-relievers, is the most shocking case of control-damage I have ever come across. It is a shame for us all that this continues.
IV. A board of policemen
Observing the lack of innovative thinking in these annual reports, one reflection is inevitable: Who are they, these members of the International Narcotics Control Board? Who are the people behind this policy? The answer is found in Annex II, pp. 69-73 where the extensive curriculum vitae for all the members of the Board are presented:
The Board has 13 members, selected through a very unclear procedure. One of the members is a former ambassador, - he is the US-representative. Then there is a graduate in Political Sciences with a long experience in various aspects of drug control. Four members have medical background. And then to the majority: Seven members have a background in various forms of police or prosecutorial activities. This is the group given the mandate to help the world community to cope with the incompatible goals of securing an ample supply of drugs to help those in pain, while at the same time preventing abuse by all others. They have not succeeded in providing drugs to those in pain. They have not been able to reduce the illegal trade and use. Their actions are carried out without concern for the enormous costs created by expansion of the penal systems. Year after year they use their considerable influence to create a system of control, which represent a danger to our civil societies. It is unfair to the Board, as it is to us all, to give such an enormously complicated task to a group with such a narrow type of qualifications.
Oslo 2000, 03-02
Nils Christie