- Email: [email protected]
The term and the vision
Responses / International Journal of Drug Policy 23 (2012) 16–23
on Economic Social and Cultural Rights, 2010) with reference to the right to health and the right to an adequate standard of living. These criticisms highlight the role of the international human rights framework in providing a readily available and legally binding set of broad indicators against which drug policy goals and harms must be assessed. For example, keeping with Colombia, a number of other human rights monitoring groups have criticised aerial fumigation with reference to a range of rights protections and affected groups, from children to indigenous peoples, and from the right to health to the use of mercenaries (Hunt, 2007; Stavenhagen, 2004; UN Committee on the Rights of the Child, 2006; UN Working Group on the Use of Mercenaries, 2007). In the case of children, the UN Committee on the Rights of the Child called for a child rights impact assessment of this policy (UN Committee on the Rights of the Child, 2006). A human rights-based approach, for me, provides the potential for the ‘unifying foundation’ the authors seek. Under this approach, harm reduction retains its strength and focus relating to drug use and related harms, and the approach Greenfield and Paoli wish to see applied to supply oriented policy not only may take place, but must, as a requirement of international law. References Barrett, D. (2011) Bolivia’s concurrent drug control and other international legal commitments. International Centre on Human Rights and Drug Policy,
19
available online at http://www.druglawreform.info/images/stories/documents/ international legal commitments.pdf. Barrett, D. (2010). Security, development and human rights: Normative, legal and policy challenges for the international drug control system. International Journal of Drug Policy, 21(2), 140–144. Barrett, D., & Nowak, M. (2009). The United Nations and Drug Policy: Towards and human rights-based approach. In A. Constantinides, & N. Zaikos (Eds.), The diversity of international law. Essays in honour of Professor Kalliopi K. Koufa (pp. 449–477). Brill/Martinus Nijhoff. Elliot, R., Csete, J., Kerr, T., & Wood, E. (2005). Harm reduction, HIV/AIDS, and the human rights challenge to global drug control policy. Health and Human Rights, 8(2), 104–113. Greenfield, V. A. & Paoli, L. (2012). If supply-oriented drug policy is broken, can harm reduction help fix it? Melding disciplines and methods to advance international drug-control policy. International Journal of Drug Policy, 23, 6– 15. Hunt, P. (2007). Special Rapportueur on the right of everyone to the highest attainable standard of physical and mental health, Oral Remarks, 21 September 2007, Bogota, Colombia. Stavenhagen, R. (2004). Report of the Special Rapporteur on the situation of human rights and fundamental freedoms of indigenous people, Rodolfo Stavenhagen, Mission to Colombia (UN Doc No E/CN.4/2005/88/Add.2, 2004). UN Committee on Economic Social and Cultural Rights (2010). Concluding observations: Colombia (UN Doc No E/C.12/COL/CO/5, 2010) para 28. UN Committee on Economic Social and Cultural Rights (2011). Concluding observations: Russian Federation (UN Doc No E/C.12/RUS/CO/5, 2011) para 29. UN Committee on the Rights of the Child (2006), Concluding observations: Colombia (UN Doc No CRC/C/COL/CO/3, 2006) para 72. UN Working Group on the question of the use of mercenaries as a means of violating human rights and impeding the exercise of the right of peoples to self-determination (2007). Mission to Ecuador (UN Doc No A/HRC/4/42/Add.2, 2007) paras 47–51. doi:10.1016/j.drugpo.2011.07.005
The term and the vision Jonathan P. Caulkins ∗ Carnegie Mellon University, Qatar Campus & Heinz College’s School of Public Policy & Management, School of Information Systems & Management, 5000 Forbes Ave., Pittsburgh, PA 15213-3890, USA
I am an unabashed fan of Greenfield and Paoli’s (2012) paper and the general idea of grounding law enforcement prioritization in a broader framework than use reduction. Fulsome praise makes for boring commentary, so I will challenge them on terms and vision. It is important to distinguish the term “harm reduction” from the underlying concept. I endorse the concept broadly, but use the term selectively because it comes with a lot of baggage. It works when speaking to public health audiences or the readership of the International Journal of Drug Policy, but is tainted within U.S. law enforcement and certain policy making communities. What matters is that supply-oriented agencies embrace the concept, not the term. To me the term has intrinsic appeal, but that’s irrelevant. How does it play with the audience one is trying to convert? If the term is a barrier, we should dispense with it. One could instead stress that enforcement agencies should “protect and serve” by pursuing “public safety” – phrases which focus attention on serious harms that law enforcement has comparative advantage at addressing.
∗ Tel.: +1 412 268 9590. E-mail address: [email protected]
More generally, couching Greenfield and Paoli’s ideas within a positive vision might increase their chances of being implemented. Greenfield and Paoli are too professional to stoop to the rhetorical excesses common in criticisms of supply-side efforts, but they are nonetheless decisively negative. Supply-oriented policies are labelled as broken, and not merely ineffective but also producing bounteous ill effects. Changing those policies requires changing the minds of people who have devoted their careers to the traditional approach. Many quite literally have risked their lives going undercover or facing down violent criminals over the barrel of a gun. Beginning the discussion by announcing that their life’s work has been worse than useless is more likely to prompt retrenchment than reform. The fact that drug markets have multiple stable equilibria offers a more constructive vision, one that I would argue is also more accurate. Drug markets have a minimum efficient operating scale (Caulkins & Reuter, 2010). When volumes are below that threshold, illegality plus modest enforcement can keep prices high and availability low. In such circumstances supply-oriented policies might be terrifically efficient. But at various times and places many drug markets tip over to a higher-volume equilibrium, with lower prices and greater availability, often through some epidemic-like spread
20
Responses / International Journal of Drug Policy 23 (2012) 16–23
of use. Once the market is large and well-established, supplyoriented interventions can be a terribly inefficient way to suppress use. Yet, even then enforcement agencies remain the only viable way to address many associated harms. Some years ago when the apartment of an elderly gentleman living downstairs was strafed in a drive-by shooting, he called the police. He didn’t demand that a treatment centre be set up next door. He didn’t ask the schools whether they were implementing a model prevention curriculum. He called the police, and as the Boston Gun Project, High-Point, and other initiatives have demonstrated, good policing can temper the behaviour of even the most noxious gangs (Kleiman, 2009). The police can say, in effect, “Tone it down or take your fight elsewhere.” For those living cheek by jowl with drug distributors, law enforcement is not a futile anachronism, but a welcome bulwark against brutal violence. So before asking leaders and rank and file of supply-oriented agencies to change their practices and self-image, we might first thank them sincerely for keeping away all the drug markets that have not matured. And it might be worth reassuring them that we know they’re still the ones we’ll call in a scrape. We appreciate them and their efforts, and it is precisely because we know they care and have so much to offer, that we grant them permission to
no longer chase the Quixotic dream of a drug-free nation, allowing them instead to focus on fulfilling their oath, “To protect and serve.” I have pitched this vision to law enforcement at multiple levels in multiple countries, and it is very well received. I believe law enforcement will embrace Greenfield and Paoli’s message if it is presented positively and delivered on their terms. It would be a tragedy if ideas with so much potential were squandered because of unwillingness to present the harm reduction message in a way that is “culturally appropriate” to the people whose behaviour it seeks to change. References Caulkins, J. P., & Reuter, P. (2010). How drug enforcement affects drug prices. In M. Tonry (Ed.), Crime and justice: A review of research (pp. 213–272). University of Chicago Press. Greenfield, V. A. & Paoli, L. (2012). If supply-oriented drug policy is broken, can harm reduction help fix it? Melding disciplines and methods to advance international drug-control policy. International Journal of Drug Policy, 23, 6– 15. Kleiman, M. A. R. (2009). When Brute force fails: How to have less crime and less punishment. Princeton, NJ: Princeton University Press. doi:10.1016/j.drugpo.2011.07.006
Harm reduction for the supply-side: Its time has come Martin Jelsma Transnational Institute, De Wittenstraat 25, 1052 AK Amsterdam, The Netherlands
In their article Greenfield and Paoli (2012) put to rigorous scrutiny the highly relevant question of whether the harm reduction concept could be usefully applied to supply-oriented policies. The question itself is not new. In the development field the idea has been tentatively played with for quite a while now with regard to policies around the cultivation of drug-linked crops in poverty and conflict-stricken environments (see for example Ikelberg, 2003; Transnational Institute, 2002; UNDP, 2003; Washington Office on Latin America, 2004). Those earlier attempts came perhaps too early to gain wider acceptance at times when the ideological fight about the concept of harm reduction even for the consumption side was still raging on at the UN level. There are several reasons why this article now comes at an appropriate moment and why I fully support their basic conclusion: “Supply-oriented policy needs mending and harm reduction appears to hold promise.” Firstly, the evidence base for traditional harm reduction programmes is now undeniable and worldwide acceptance has grown spectacularly over past years (EMCDDA, 2010; Harm Reduction International, 2009). Secondly, despite the disappointing outcomes in 2009 of the 10-year drugs UNGASS review and its introduction of yet another vague euphemism for harm reduction with the phrasing “related support services”, the troubled process did bring about a clearer recognition that supply reduction efforts have failed to reduce the extent of the global
E-mail address: [email protected]
market. The evaluation report commissioned by the European Commission leaves no doubt about that (Reuter et al., 2009). But the United Nations Office on Drugs and Crime also acknowledged as much by introducing the terminology of market “containment” replacing the illusionary objective of a “drug free world”. Thirdly, there is demonstrable interest on the law enforcement side to redirect their anti-drugs mission towards more obtainable objectives and to think in terms of reductions of drug-related violence and insecurity (see for example the special issue on Law enforcement to reduce drug harms in Safer Communities, 2009). And finally, the prestigious Global Commission on Drug Policy report (2011) helps to shift the terms of the debate also with regard to supply-oriented policies. Their recently launched report calls for strategies “to manage and shape the illicit market” because those “can be much more effective in reducing market-related violence and harms than futile attempts to eradicate the market entirely.” Even though the time has come for introducing harm reduction in supply-oriented drug policy making, its application in practice and theory requires time to take root, grow and ripen. Jumping to a complex analytical framework and matrix-like construct to quantify harms and calculate policy priorities, as the authors acknowledge, would at this stage be “messy at best”. Harm reduction on the consumption side developed from practice, not from theoretical constructs. The same will happen on supply side. The priority therefore is to start experimenting with attempts to reduce the most obvious harms related to drugs markets and to supply-reduction interventions. Showing effectiveness
on Economic Social and Cultural Rights, 2010) with reference to the right to health and the right to an adequate standard of living. These criticisms highlight the role of the international human rights framework in providing a readily available and legally binding set of broad indicators against which drug policy goals and harms must be assessed. For example, keeping with Colombia, a number of other human rights monitoring groups have criticised aerial fumigation with reference to a range of rights protections and affected groups, from children to indigenous peoples, and from the right to health to the use of mercenaries (Hunt, 2007; Stavenhagen, 2004; UN Committee on the Rights of the Child, 2006; UN Working Group on the Use of Mercenaries, 2007). In the case of children, the UN Committee on the Rights of the Child called for a child rights impact assessment of this policy (UN Committee on the Rights of the Child, 2006). A human rights-based approach, for me, provides the potential for the ‘unifying foundation’ the authors seek. Under this approach, harm reduction retains its strength and focus relating to drug use and related harms, and the approach Greenfield and Paoli wish to see applied to supply oriented policy not only may take place, but must, as a requirement of international law. References Barrett, D. (2011) Bolivia’s concurrent drug control and other international legal commitments. International Centre on Human Rights and Drug Policy,
19
available online at http://www.druglawreform.info/images/stories/documents/ international legal commitments.pdf. Barrett, D. (2010). Security, development and human rights: Normative, legal and policy challenges for the international drug control system. International Journal of Drug Policy, 21(2), 140–144. Barrett, D., & Nowak, M. (2009). The United Nations and Drug Policy: Towards and human rights-based approach. In A. Constantinides, & N. Zaikos (Eds.), The diversity of international law. Essays in honour of Professor Kalliopi K. Koufa (pp. 449–477). Brill/Martinus Nijhoff. Elliot, R., Csete, J., Kerr, T., & Wood, E. (2005). Harm reduction, HIV/AIDS, and the human rights challenge to global drug control policy. Health and Human Rights, 8(2), 104–113. Greenfield, V. A. & Paoli, L. (2012). If supply-oriented drug policy is broken, can harm reduction help fix it? Melding disciplines and methods to advance international drug-control policy. International Journal of Drug Policy, 23, 6– 15. Hunt, P. (2007). Special Rapportueur on the right of everyone to the highest attainable standard of physical and mental health, Oral Remarks, 21 September 2007, Bogota, Colombia. Stavenhagen, R. (2004). Report of the Special Rapporteur on the situation of human rights and fundamental freedoms of indigenous people, Rodolfo Stavenhagen, Mission to Colombia (UN Doc No E/CN.4/2005/88/Add.2, 2004). UN Committee on Economic Social and Cultural Rights (2010). Concluding observations: Colombia (UN Doc No E/C.12/COL/CO/5, 2010) para 28. UN Committee on Economic Social and Cultural Rights (2011). Concluding observations: Russian Federation (UN Doc No E/C.12/RUS/CO/5, 2011) para 29. UN Committee on the Rights of the Child (2006), Concluding observations: Colombia (UN Doc No CRC/C/COL/CO/3, 2006) para 72. UN Working Group on the question of the use of mercenaries as a means of violating human rights and impeding the exercise of the right of peoples to self-determination (2007). Mission to Ecuador (UN Doc No A/HRC/4/42/Add.2, 2007) paras 47–51. doi:10.1016/j.drugpo.2011.07.005
The term and the vision Jonathan P. Caulkins ∗ Carnegie Mellon University, Qatar Campus & Heinz College’s School of Public Policy & Management, School of Information Systems & Management, 5000 Forbes Ave., Pittsburgh, PA 15213-3890, USA
I am an unabashed fan of Greenfield and Paoli’s (2012) paper and the general idea of grounding law enforcement prioritization in a broader framework than use reduction. Fulsome praise makes for boring commentary, so I will challenge them on terms and vision. It is important to distinguish the term “harm reduction” from the underlying concept. I endorse the concept broadly, but use the term selectively because it comes with a lot of baggage. It works when speaking to public health audiences or the readership of the International Journal of Drug Policy, but is tainted within U.S. law enforcement and certain policy making communities. What matters is that supply-oriented agencies embrace the concept, not the term. To me the term has intrinsic appeal, but that’s irrelevant. How does it play with the audience one is trying to convert? If the term is a barrier, we should dispense with it. One could instead stress that enforcement agencies should “protect and serve” by pursuing “public safety” – phrases which focus attention on serious harms that law enforcement has comparative advantage at addressing.
∗ Tel.: +1 412 268 9590. E-mail address: [email protected]
More generally, couching Greenfield and Paoli’s ideas within a positive vision might increase their chances of being implemented. Greenfield and Paoli are too professional to stoop to the rhetorical excesses common in criticisms of supply-side efforts, but they are nonetheless decisively negative. Supply-oriented policies are labelled as broken, and not merely ineffective but also producing bounteous ill effects. Changing those policies requires changing the minds of people who have devoted their careers to the traditional approach. Many quite literally have risked their lives going undercover or facing down violent criminals over the barrel of a gun. Beginning the discussion by announcing that their life’s work has been worse than useless is more likely to prompt retrenchment than reform. The fact that drug markets have multiple stable equilibria offers a more constructive vision, one that I would argue is also more accurate. Drug markets have a minimum efficient operating scale (Caulkins & Reuter, 2010). When volumes are below that threshold, illegality plus modest enforcement can keep prices high and availability low. In such circumstances supply-oriented policies might be terrifically efficient. But at various times and places many drug markets tip over to a higher-volume equilibrium, with lower prices and greater availability, often through some epidemic-like spread
20
Responses / International Journal of Drug Policy 23 (2012) 16–23
of use. Once the market is large and well-established, supplyoriented interventions can be a terribly inefficient way to suppress use. Yet, even then enforcement agencies remain the only viable way to address many associated harms. Some years ago when the apartment of an elderly gentleman living downstairs was strafed in a drive-by shooting, he called the police. He didn’t demand that a treatment centre be set up next door. He didn’t ask the schools whether they were implementing a model prevention curriculum. He called the police, and as the Boston Gun Project, High-Point, and other initiatives have demonstrated, good policing can temper the behaviour of even the most noxious gangs (Kleiman, 2009). The police can say, in effect, “Tone it down or take your fight elsewhere.” For those living cheek by jowl with drug distributors, law enforcement is not a futile anachronism, but a welcome bulwark against brutal violence. So before asking leaders and rank and file of supply-oriented agencies to change their practices and self-image, we might first thank them sincerely for keeping away all the drug markets that have not matured. And it might be worth reassuring them that we know they’re still the ones we’ll call in a scrape. We appreciate them and their efforts, and it is precisely because we know they care and have so much to offer, that we grant them permission to
no longer chase the Quixotic dream of a drug-free nation, allowing them instead to focus on fulfilling their oath, “To protect and serve.” I have pitched this vision to law enforcement at multiple levels in multiple countries, and it is very well received. I believe law enforcement will embrace Greenfield and Paoli’s message if it is presented positively and delivered on their terms. It would be a tragedy if ideas with so much potential were squandered because of unwillingness to present the harm reduction message in a way that is “culturally appropriate” to the people whose behaviour it seeks to change. References Caulkins, J. P., & Reuter, P. (2010). How drug enforcement affects drug prices. In M. Tonry (Ed.), Crime and justice: A review of research (pp. 213–272). University of Chicago Press. Greenfield, V. A. & Paoli, L. (2012). If supply-oriented drug policy is broken, can harm reduction help fix it? Melding disciplines and methods to advance international drug-control policy. International Journal of Drug Policy, 23, 6– 15. Kleiman, M. A. R. (2009). When Brute force fails: How to have less crime and less punishment. Princeton, NJ: Princeton University Press. doi:10.1016/j.drugpo.2011.07.006
Harm reduction for the supply-side: Its time has come Martin Jelsma Transnational Institute, De Wittenstraat 25, 1052 AK Amsterdam, The Netherlands
In their article Greenfield and Paoli (2012) put to rigorous scrutiny the highly relevant question of whether the harm reduction concept could be usefully applied to supply-oriented policies. The question itself is not new. In the development field the idea has been tentatively played with for quite a while now with regard to policies around the cultivation of drug-linked crops in poverty and conflict-stricken environments (see for example Ikelberg, 2003; Transnational Institute, 2002; UNDP, 2003; Washington Office on Latin America, 2004). Those earlier attempts came perhaps too early to gain wider acceptance at times when the ideological fight about the concept of harm reduction even for the consumption side was still raging on at the UN level. There are several reasons why this article now comes at an appropriate moment and why I fully support their basic conclusion: “Supply-oriented policy needs mending and harm reduction appears to hold promise.” Firstly, the evidence base for traditional harm reduction programmes is now undeniable and worldwide acceptance has grown spectacularly over past years (EMCDDA, 2010; Harm Reduction International, 2009). Secondly, despite the disappointing outcomes in 2009 of the 10-year drugs UNGASS review and its introduction of yet another vague euphemism for harm reduction with the phrasing “related support services”, the troubled process did bring about a clearer recognition that supply reduction efforts have failed to reduce the extent of the global
E-mail address: [email protected]
market. The evaluation report commissioned by the European Commission leaves no doubt about that (Reuter et al., 2009). But the United Nations Office on Drugs and Crime also acknowledged as much by introducing the terminology of market “containment” replacing the illusionary objective of a “drug free world”. Thirdly, there is demonstrable interest on the law enforcement side to redirect their anti-drugs mission towards more obtainable objectives and to think in terms of reductions of drug-related violence and insecurity (see for example the special issue on Law enforcement to reduce drug harms in Safer Communities, 2009). And finally, the prestigious Global Commission on Drug Policy report (2011) helps to shift the terms of the debate also with regard to supply-oriented policies. Their recently launched report calls for strategies “to manage and shape the illicit market” because those “can be much more effective in reducing market-related violence and harms than futile attempts to eradicate the market entirely.” Even though the time has come for introducing harm reduction in supply-oriented drug policy making, its application in practice and theory requires time to take root, grow and ripen. Jumping to a complex analytical framework and matrix-like construct to quantify harms and calculate policy priorities, as the authors acknowledge, would at this stage be “messy at best”. Harm reduction on the consumption side developed from practice, not from theoretical constructs. The same will happen on supply side. The priority therefore is to start experimenting with attempts to reduce the most obvious harms related to drugs markets and to supply-reduction interventions. Showing effectiveness