Put morality aside — drug liberalization works, says ex-New Zealand PM 

Politicians should put moral or political concerns aside and consider a radical rethink of their drug laws — including decriminalization — to protect public health, former New Zealand Prime Minister Helen Clark told POLITICO.

Speaking ahead of the launch of a report showing that the world is failing to reduce HIV and viral hepatitis cases among people who inject drugs, Clark said measures such as drug consumption rooms, needle exchanges and decriminalization would help make progress in combating these infectious diseases.

“If we don’t address what’s driving the risk, then we can’t get on top of the disease," Clark said. “So you need to be very, very pragmatic, put whatever morality, whatever issues you have, aside — because that is standing in the way of dealing with a disease challenge in the society.’”

Wednesday’s report from the Global Commission on Drug Policy, of which Clark is chair, calls for countries to decriminalize drug use and possession for personal use in order to reduce associated health risks.

It points to evidence associating criminalization of drug possession and use with poorer health outcomes for people who inject drugs, as well as higher HIV prevalence; and that involvement with the criminal justice systems “directly increases the risk for HIV and viral hepatitis.”

Clark told POLITICO that “the criminalization of people who use drugs or possess drugs for personal use (or paraphernalia) is all counterproductive” in efforts to reduce harm to health.

Scotland, which has the highest drug death rate in Europe, recently approved the first drug consumption room in the United Kingdom after prosecutors were told it would "not be in the public interest" to prosecute users of the facility. Clark said public support for drug consumption rooms gave the Scottish government a mandate to push ahead with the facility in the face of opposition from the U.K. government.

“I think it requires political leaders to come up to speed with the reality of what’s happening in the community and what will address these issues,” she said. Clark pointed to New Zealand, Switzerland and Portugal as countries that liberalized drug policies — and maintained that approach despite changes in government. “If it works, people stick with it,” she said.

Yet liberalized drug policies remain the exception, not the norm. Asked why this is, Clark said that governments are “not joining the dots” between the public health implications and their drug policies. “They tend to think in silos. But if you don’t deal with the basic issue of criminalization, you can’t deal with the issues effectively,” she said.

One factor that might make governments reticent to relax drug laws is that not all governments that have tried it appear to have succeeded. In Oregon in the United States, decriminalizing hard drugs is seen by some to have failed, with widespread public drug abuse.

But Clark’s argument is that restrictive laws around drugs haven’t stopped drug use — and indeed, only make it harder to access public health interventions. “The reason people use drugs obviously [has] nothing to do with what the state of the law is,” she said. “People use drugs even in the face of the death penalty.”

The findings from the Global Commission — whose members include former Polish President Aleksander Kwaśniewski; Nick Clegg, former deputy prime minister in the U.K.; and Kgalema Motlanthe, former president of South Africa — also reveal that the prevalence of HIV and current hepatitis C infection in injecting drug users is highest in Eastern Europe. There, more than a third of users are HIV-positive and more than 48 percent have a current hepatitis C infection, which results in inflammation of the liver.

Although the United Nations has set targets for ending HIV and hepatitis by 2030, the report argues that “the continued failure to systematically confront HIV and viral hepatitis among people who use drugs will thwart global efforts.”

Clark said: “If we want to reach targets for eliminating these viral diseases as public health threats, we have to get down to some of the core issues, which are what stands in the way of people accessing services and treatment, and the criminalization and the whole stigma that’s associated with that.”