Representing different political, cultural and socio-economist contexts, CEECA countries continue to apply prohibition approach and punitive sanctions for drug possession for personal use.
Massive incarceration of people who use drugs is the most obvious, but not the only negative consequence of criminalisation of drug use or possession for personal use. Criminalisation affects health – the fear of police prosecution increases the use of unsterile syringes and thus fuels HIV and viral hepatitis epidemics; overdose mortality rates are also, to a big extend, driven by harsh drug policies. Punitive sanctions for drugs create barriers to social reintegration of people who use drugs decreasing their chance for employment, education and vocational training and, most importantly, building social and family relations.
Punitive sanctions for drug use and possession exit in various forms – it can be years of prison sentences, or arrest for several days, fines or correctional works. While an arrest or a fine cause less harm to health and social wellbeing of an individual than a longterm imprisonment, the substance remains the same – it is a sanction, a punishment, which is aim is to cause suffering, but not to help. Thus real alternatives to criminal sanctions for drugs are not administrative fines but programs that refer people who use drugs to health or social service that they need.
Such referral can be made at the point of arrest and include access to harm reduction programs, opioid substitution and other drug treatment, HIV testing and treatment, mental health programs, vocational training, employment, housing etc. There is growing evidence that diversion from arrest programs cost less and are more effective in terms of decreasing the criminal behaviour (for more information see https://www.leadbureau.org/).
In CEECA diversion from arrest programs only start to be implemented. Pilot programs are run in Estonia and Lithuania, while in a number of countries – Georgia, Ukraine, Kyrgyzstan and Tajikistan – their initiation is discussed by national stakeholders. However, the region will go a long way to reorient its drug policies to humanistic and right-based approach.
In fact, any social belief or stereotype built on the thesis that people who use drugs are less worthy of social benefits than those who do not use drugs is a form of violence in itself. Social stigma associated with drugs and criminalisation lead to systematic discrimination of people who use drugs in the healthcare system: they are often denied effective drug treatment such as opioid substitution treatment, HIV and viral hepatitis prevention and treatment, access to pain management, etc. In particular, women who use drugs suffer from disproportional damage: they are deprived of parental rights, they have limited access to sexual and reproductive health care services (especially during pregnancy), they are subjected to brutal police and domestic violence. Their stigmatisation is complex and multifaceted, which makes them much more susceptible and vulnerable to HIV and other infections.
In CEECA, in general, the institutes of the protection of human rights of vulnerable populations are underdeveloped, while there are significant differences in factors that explain low access to and limited efficiency in using human rights instruments. In addition to that, extremely low interest to human rights violations experienced by people who use drugs among ‘mainstream’ human rights and gender rights movements can be explained by extremely high stigma around drug-related issues. In this context, the central role in documenting human rights violation and analysing them through the prism of international and national legislation has to be given to people who use drugs and their ‘traditional allies’ – harm reduction programs.