The United Nations General Assembly recently convened a special session on drugs, marking its first meeting on the topic since 1998. As part of the proceedings, Northeastern University drug policy expert Leo Beletsky spoke at one of the session’s side events, delivering a talk to policy makers and academics titled “HIV, Drugs, and the Legal Environment.” Throughout his career, Beletsky, associate professor of law and health sciences, has worked to harness the power of the law to help curb substance abuse, prevent the spread of HIV, and improve patient care. Here, he reflects on the historic meeting and the future of drug policy reform.

 

The special session on drug policy marked the first meeting of its kind since 1998, when its focus was reported to be the worldwide elimination of drugs. How has the U.N. General Assembly’s approach to tackling the world’s drug problem evolved over the past 18 years?

This session of the General Assembly was in some ways different and in some ways similar to the last UNGASS in 1998. On the one hand, it was different because there is now a more pronounced and noticeable push for reform. This movement is spurred by the success of efforts around the world, including in Portugal, Canada, and right here in the U.S. There is mounting evidence and pretty strong scientific consensus that drug policies based on punishment and incarceration do more harm than good, sometimes actually fueling the problems they seek to ameliorate. On the other hand, the actual resolution document of the recent UNGASS event is not a significant departure from the vision of the “drug-free world” articulated in 1998. This is because the politics of the U.N. are such that member states such as Russia and China that oppose reform were able to effectively block meaningful reform efforts. Many complain that policy change in the U.S. is slow; under the U.N. system, it is even slower.

Business magnate Richard Branson criticized the special session on drug policy in an op-ed for The Guardian, writing that its outcome document “is out of step with mounting evidence and with public sentiment.” In your view, how successful has UNGASS been at addressing the flaws of international drug policy?

Some advocates and member states had called for the overhaul of the U.N.’s principal treaty on drugs: The Single Convention on Narcotic Drugs, which is clearly outdated. On the one hand, this treaty has failed to curb substance misuse, as we see so clearly illustrated here in the U.S.. At the same time, we observe severe—and unnecessary—shortages of important medicines like opioid painkillers in many parts of the world. The recent UNGASS in and of itself did not move us any closer to such an overhaul or meaningful reforms of the U.N.’s other outdated regulatory system. What it did do, however, is effectively call attention to the need for reform all across the world. Only time will tell if this will facilitate meaningful change on the national and local level.

In the past, you’ve noted that policing the nation’s drug problem through incarceration has “proven expensive, ineffective, and deadly for far too many people.” If you were part of the General Assembly, what policy recommendations would you make to improve the worldwide response to drug use and abuse?

I support the aspiration of the Obama administration and an increasing number of other governments around the world to respond to problematic drug use through a public health approach. Precise ways to define such an approach vary, but the basic principle is to focus on reducing the harms of substance misuse using tools that we know are effective and cost-effective. For example, this means shifting our attention to effective treatment instead of incarceration. It also means transforming the role of law enforcement to facilitate public health interventions, as I discuss in a recent piece for The Crime Report.