Category: Blog Post
Posted: May 6 2015
Author: Nazlee Maghsoudi

Is Prohibition Protecting Youth? A Look at the Scientific Evidence

The ICSDP asked the United Nations to take a hard look at the scientific evidence during a Civil Society Hearing held last month.

As part of the preparations for the biggest international meeting on drugs since 1998, also known as the upcoming United Nations General Assembly Special Session on Drugs (UNGASS) in 2016, a High-level Thematic Debate took place at the UN in New York on May 7, 2015. The ICSDP’s Nazlee Maghsoudi made a formal statement asking the UN to consider whether scientific evidence suggests that prohibition has been effective at protecting youth.

ICSDP research has found that based on supply indicators, the accessibility of illegal drugs has risen despite increasing investments in enforcement-based supply reduction efforts. Given that prices have fallen and purity has increased, current drug polices have not been proven to be able to reduce the access of illegal drugs to young people. Nazlee suggested that strict legal regulation of illegal drug markets may be more effective at limiting youth access, particularly through regulatory controls such as age restrictions. Moreover, Nazlee explained that in order to protect the health of young people, the scale up of harm reduction services is necessary (including youth friendly and targeted services). Evidence from Switzerland finds that the scale up of harm reduction services not only prevents the spread of blood borne diseases, but also reduces injecting initiation, a risk behaviour to which youth are particularly vulnerable. Nazlee’s remarks on the failure of current drug policies to protect youth was especially timely given the upcoming UNGASS, the slogan of which is “a better tomorrow for the world’s youth.” Watch Nazlee deliver her statement or read the transcript for yourself below.

Nazlee’s statement was also covered by Transform Drug Policy Foundation and Canadian Students for Sensible Drug Policy. For an overview of all the statements made at the Civil Society Hearing, check out the CND Blog.

“I’d like to thank the Civil Society Task Force for inviting me to speak today, and thank everyone here for attending. As mentioned, my name is Nazlee Maghsoudi. As you may be able to tell, I am a young person, and I was asked to bring the youth perspective to this panel. In my role on the Board of Directors at Canadian Students for Sensible Drug Policy, as well as my involvement with a nightlife harm reduction program that provides services to youth in Toronto, I have worked closely with young people who use drugs and who have been negatively impacted by our current drug policies. I am also representing the International Centre for Science in Drug Policy, an international network of scientific, medical, and academic experts in fields related to illicit drug policy that work to ensure that drug policies are informed with the best available scientific evidence. Hence, my comments today are informed by my on the ground experience with youth as well as my belief that drug policy must be guided by science and evidence, and when the research indicates that something isn’t working, change is essential.

I’d like to focus on article 33 of the Convention on the Rights of a Child, as this comes up time and time again in the discussion of drug policy and the need to protect young people from illegal drugs. As the only explicit mention of narcotic drugs and psychoactive substances in international human rights law, according to article 33, “States Parties shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances as defined in the relevant international treaties.” We can all agree that protecting youth is of the utmost importance. What I would like to focus on today is the extent to which scientific evidence demonstrates that a punitive approach to drug policy is the most “appropriate measure” for protecting youth. I should note that the evidence I am presenting today will, in the interests of time, only focus on a few of the many negative health and social outcomes that youth experience as a result of conventional drug policies.

Evidence has repeatedly shown us that conventional approaches to drug policy, particularly supply reduction efforts, have been ineffective in meaningfully reducing the accessibility of illegal drugs among youth. As anyone working at the grassroots level with young people can tell you, it is no secret that youth have pretty unrestricted access to illegal drugs. Drug dealers do not check IDs, and the nearest supply may be just a phone call or a few lockers away. Research conducted by the US National Institutes on Drug Abuse confirm this, as for the past 39 years, between 81% and 90% of twelfth graders have reported that they could obtain cannabis fairly easily or very easily. This extremely high level of cannabis availability among young people has been sustained despite substantial increases in the US federal drug control budget, indicating that increased efforts to enforce cannabis prohibition have been unsuccessful in preventing youth from accessing cannabis in the US. Similarly in the European Union, research from the past year has indicated that 58% of young people aged 15 to 24 believe it would be either very easy or fairly easy to obtain cannabis within 24 hours. Other metrics of supply also demonstrate that access to illegal drugs, particularly among youth, has been for the most part unaffected by drug control efforts, and in some cases, the availability of illicit drugs is greater than ever before. Peer-reviewed research from the International Centre for Science in Drug Policy has shown that since 1990, despite increasing investments in enforcement-based supply reduction efforts aimed at disrupting global drug supply, illegal drug prices have generally decreased while drug purity has generally increased. This means that, among today’s youth, the availability of illegal drugs is generally greater than ever before. We can therefore conclude that prohibition has not been shown to be the “most appropriate” measure for protecting children from illicit drugs.

Given that supply reduction has been unsuccessful in significantly or sustainably reducing the availability of most illicit drugs, it is time to consider whether alternative approaches may be more effective in doing so. By allowing governments to set legal age restrictions, the strict legal regulation of illicit drug markets could – perhaps counter intuitively – actually be more effective than prohibition at restricting the accessibility of illegal drugs among young people. Age restrictions can be used to prevent the purchase of illegal drugs by youth, thereby changing the current situation – unfettered access to cannabis, for example – to one in which obtaining cannabis is no longer perceived as fairly easy or very easy. This does not discount the paramount importance of prevention efforts, which are of course vital to protecting youth from beginning to misuse illegal drugs. But as we have seen in the case of tobacco, market and regulatory controls combined with public health education can be effective in reducing use, and therefore protecting youth from the harms of drugs, without resorting to mass criminalization or harsh prohibitions. The Framework Convention on Tobacco Control shows us that an international regulatory framework for non-medical and non-scientific uses of a drug is possible. Different contexts will call for different regulatory measures – a one-size-fits all approach will not be appropriate for every state or every substance. However, taking control of currently unregulated illegal drug markets can give states the tools to meaningfully limit youth access to drugs, something which has plainly not been possible using our current policy tools where all control is abdicated to unregulated criminal entrepreneurs. Strict legal regulation is therefore a promising alternative to prohibition and may be a more appropriate measure for protecting children from illicit drugs.

The increased accessibility of illegal drugs among young people is just one way in which conventional approaches to drug policy have failed to protect youth. According to the World Health Organization, data suggests that a substantial proportion of the global population of people who inject drugs began injecting as adolescents. And because young people who inject are more likely to engage in risky behaviours like sharing non-sterile injecting equipment, they are more vulnerable to HIV infection than older people who inject drugs. Nevertheless, the scale up of youth targeted harm reduction services (including in the form of the comprehensive package recommended by the WHO, UNAIDS, and UNODC) is scarce, leaving young people who inject drugs without the means to realize their right to health. Other barriers preventing youth access to harm reduction services, such as legal age restrictions and requirements for parental consent, are also widespread. Given that young people aged 15 to 24 account for 40% of all new HIV infections worldwide, preventing injection among young people represents a key global health concern. To that end, drug policies that inhibit the access of young people to harm reduction services fuel the public health crisis of HIV, as well as epidemics of HCV.

Scaling up harm reduction services can have a dramatic impact on reducing the risk behaviours that increase the vulnerabilities of young people to blood borne diseases. The experience in Switzerland is quite illustrative. In the 1990s, a national policy of harm reduction was implemented in Switzerland, which involved scaling up supervised injection facilities, needle and syringe programs, and methadone maintenance therapy. Not only did this have a major impact on HIV prevention, it also had a secondary impact of reducing the incidence of injecting initiation. After harm reduction was scaled up, the proportion of new injectors in Switzerland dropped by over 80%, showing that this policy change was reducing the risk that young people were beginning to inject drugs. This is an unprecedented success story in preventing harmful drug use, accomplished using a health-oriented drug policy framework. If we recall that the majority of people who inject drugs initiate injecting as adolescents, interventions that lead to reductions in injection drug use will therefore have a dramatic impact on improving the health and wellbeing of young people.

My work at the grassroots level has taught me that the absence of harm reduction programs sends a very troubling and stigmatizing message to young people who use drugs – that their health is not important. Not all young people can be protected from illegal drug use, despite even the most effective demand reduction efforts. Yet, for those young people that decide to use illegal drugs, the harms associated with that use could be significantly mitigated via harm reduction services, like providing sterile syringes or a safe, medically-supervised place to inject. Many of the deaths in the communities I work with could have been directly prevented if harm reduction services had been available. Surely, the need to protect youth as required by article 33 includes provision of proven harm reduction interventions to those that choose to use illegal drugs. This proposal is supported by the Committee on the Rights of the Child, the body tasked with interpreting article 33, as the Committee has indicated that  the development of specialized and youth-friendly harm reduction services for children and young people is vital.

We cannot afford to overlook the potential positive impacts of an evidence-based approach to drug policy, one that includes the scaling up of harm reduction services and the strict legal regulation of currently illegal drugs under a public health framework. Based on my experiences working with young people and the evidence I have shared today, such as approach – based on public health, science and compassion – is a more “appropriate measure” for protecting youth than the current criminal justice led model based on a counterproductive preoccupation with punishment.

Thinking about how effective the measures used thus far have been at protecting youth is especially timely given the slogan of the upcoming United Nations General Assembly Special Session on Drugs, which is “a better tomorrow for the world’s youth.” I urge member states, UN agencies, and other stakeholders to keep this slogan in the forefront of their minds as they prepare for the UNGASS. We must seriously consider whether the measures that have been used for the past fifty years, the measures which evidence has shown have been unsuccessful based on their own metrics of success, and which have created a plethora of negative consequences, can be expected to contribute to a better tomorrow for the world’s youth. Thank you.”

Photo above by Charles Smith.