The politicians were right: marijuana kills. Especially when swallowed wrapped up in a plastic bag, while fleeing the police.
In Ukraine dozens of thousands of drug users are convicted for the deeds, which are not considered to be crimes in most civilized countries altogether (e.g. 0.005 of acetylated opium or heroin in Ukraine vs. 0.5 g in Russia or 1-3 g in most EU countries). Thus every tenth inmate (13 500 persons per year) at a penal facility is an average drug dependent person who rather needs medical treatment and social support than incarceration. While police imitate fight against drug trafficking, criminal persecution of drug users and consistent cases of police misconduct become the drivers for HIV/AIDS, tuberculosis and hepatitis epidemics in Ukraine.
On 28 August, 2013 Ukrainian Cabinet of Ministers approved the National State Strategy on Drugs (the Strategy) -- the first document of this kind in Ukraine, quite progressive and liberal. This Strategy proclaims a really balanced approach towards drugs, changing overall frame from "combatting drugs" and defining them as "absolute evil" to "addressing drugs". This approach is perceived even in the title of the document: all previous documents bore names like “”Concept on combating drugs…”, this document is titled “Strategy on drugs”.
The document entails not only controlling “police” measures to prevent illegal drug trafficking, but also, what is very important, includes measures on opioids’ accessibility for medical use. This is especially crucial for patients who need pain relief and patients of opioid substitution treatment programs.
Among other positive aspects of the new document we want to emphasize the following:
Decriminalization of minor drug possession--that is, reducing criminal penalties for simple drug-related offences by increasing minimal dosages for drug possession;
Changing police performance assessment criteria. Currently statistics is the main criteria to evaluate police performance, and this system provides incentives for more arrest/imprisonment.Drug users are very easy and convenient target for police to increase their “success rate” and demonstrate (imitate) their fight against drugs;
Establishing harm reduction status as legal: the current draft includes a chapter on harm reduction, covering needle exchange and OST;
Treatment for drug users at penitentiary settings: provision of “…all possible treatment services, including pharmacological programs (including detox)…”. The Strategy does not mention specifically OST, but since OST is a nedication-based program, there remains a window of opportunities (sure political will of State Penitentiary Service is essential here);
Gender-oriented approach: pregnant women who use drugs should obtain proper pre-natal care;
General practitioners (family doctors) should prescribe opioids for medical use (pain relief, OST), which is crucial for better coverage in the context of healthcare reform in Ukraine.
The Strategy by itself will not have direct implications for the practical developments. But certainly it is a strong platform for further advocacy for better policies and practices in Ukraine.
The Strategy was initiated by the State Service on Drug Control and developed with support of many stakeholders: International Renaissance Foundation (IRF) in cooperation with Public Health Program of the Open Society Foundation (OSF), UNODC, The Pompidou Group of Council of Europe and other national and international experts. IRF and OSF supported national and international policy analysis study and conducted series of public hearings to discuss the draft of the Strategy in 2012. This victory could not be possible without strong commitment from the State Service on Drug Control and many efforts undertaken by the partners.
Olena Kucheruk, Public Health Program, International Renaissance Foundation. www.irf.ua