The new report by the Global Commission on Drug Policy, Drug Policy and the Deprivation of Liberty, calls for more sustainable and far-reaching reforms in drug policy. 

The Global Commission stresses that we can no longer ignore the current situation of incarceration and related human rights violations and urgently call for political, correctional, and medical authorities to face up to their responsibilities.

Released this week, the position paper provides an overview of the present situation relating to incarceration and drugs –  profiling prisons worldwide, custodial and pre-trial detention, and a detailed profile on who the people are who use drugs and prisons. 

Today, more than 10 million people are incarcerated world-wide. One in five is incarcerated for drug-related offenses and of these, 83 per cent serve sentences merely for drug possession for personal use.  The commission considers incarceration as an expression of the failures of prohibition-based drug policies to achieve their goals, and of the failure to implement policies that would prioritise the health and rights of individuals and communities over criminal justice approaches.

The report covers the right to health in prisons, obligations under international law, poorly prepared prison releases and associated health risks. 

States have the responsibility to protect the right to health of those deprived of liberty, and incarcerated people should enjoy the same standards of health care as those available in the community. This applies to everyone on a non-discriminatory basis, including people who use drugs and drug-dependent people. States have largely failed to meet this standard.

In 2016 only 52 countries provided opioid maintenance treatment in prisons. The situation is worse for needle and syringe programs, provided in prisons in only 10 countries, as resistance to their implementation remains high among authorities and prison staff. HIV, hepatitis C, and tuberculosis treatment are also often less available in prison environments. 

“Even though they are banned, the reality is that illegal drugs and other psychoactive substances are largely prevalent in prison. Thus, if incarcerated people consuming drugs also lack access to the means that would allow them to reduce the harms associated with use, they will be exposed to health risks that are far greater than they might otherwise be outside of prison,“ says Ruth Dreifess, former President of Switzerland. 

Special attention needs to be given to the risks to which people who use drugs are exposed when released from prison, as the transition towards their previous lives is marked by higher overdose rates than in the general population.

The recommendations given in the paper are to address what the commission refers to as ‘the perfect storm’ of prison overcrowding and inadequate healthcare for vulnerable people. 

  • States must end all penalties – both criminal and civil – for the possession and cultivation of drugs for personal consumption.
  • States must end disproportionate sentencing and punishment for drug-related offences, and recognise that over-incarceration negatively impacts on public health and social cohesion.
  • States must ensure primary health care is available and the right to health is applicable to all people on a non-discriminatory basis, including people detained against their will.
  • Practices that violate human rights of people deprived of liberty must be forbidden, their perpetrators brought to justice, and compensation awarded to victims as provided for in human rights law.