UNODC publishes a technical note on drug policies and sustainable development

After the launch, last week, of the World Drug Report 2016, the United Nations Office on Drugs and Crime (UNODC) in Brazil published a technical note on the report as a contribution to the debate on the subject in the country.

The World Drug Report 2016 takes place in a remarkable moment, after a special session of the General Assembly (UNGASS) on the world drug problem and the first after the launch of the 17 Sustainable Development Goals of the United Nations.

The problem of drug use is global and interconnected with all sustainable development aspects. Its analysis and subsequent response, through the Sustainable Development Goals (SDGs), reveal this interaction, cutting across the nature and dynamics of the problem in the individual, community and national levels.

The 17 SDGs were divided into five broad areas: social development; economic development; environmental sustainability; peaceful, fair and inclusive societies; and partnerships.


Reduced inequalities 

Reduce inequality within and among countries

Regarding the SDG 10 (reduce inequality within and among countries), it is important to note that difficulty in accepting or understanding that drug addiction is a health condition enhances the marginalization cycle that usually affects people with drug use related disorders, hindering their treatment and social integration. The stigmatization of people who use drugs may pose a major barrier for these people to access health care actions, as demonstrated by the study of Brazilian researcher Telmo Ronzani quoted in the Report.

The Report draws attention to the link between  social exclusion, stigmatization and drug use. It is important to highlight that not all people who use drugs are marginalized and not all marginalized people make use of drugs. Nevertheless, social marginalization can be seen as a risk factor for drug abuse.

Due to the difficulties of considering marginalization as an indicator to be measured, there are other factors that can be considered in the evaluation of social conditions, such as unemployment, homelessness, incarceration, violence, among others.

The practice of drug use can contribute to the process of marginalization due to the stigma and discrimination experienced by people who use drugs in certain contexts, causing a negative impact on employment opportunities and social bonds, might lead to the loss of human capital.

In many cases, people can get in cycles involving problematic use of drugs in a complex and reciprocal causal relationship that is difficult to be broken. As shown in the graph below, this cycle involves disorders associated with the use of drugs, unemployment contexts, low education levels, housing problems, migration, exchange of sex for drugs, incarceration, higher vulnerability to infections due transmission by blood and sex, social exclusion and stigmatization. The Report refers a survey conducted by the Oswaldo Cruz Foundation (, which indicated a social vulnerability profile among crack users prior to the use of crack, but can also be made worse by it. This quantitative research was recently detailed in Brazil with a sociological investigation that sought to reconstitute crack users life trajectories ("Crack and Social Exclusion" - Organizer: Jesse Souza).

Thus, in addition to prevention policies aimed at promoting education and welfare and care in the health field for treatment actions, rehabilitation and social reintegration, based on evidence, these policies also require a strong coping component to stigmatization and promote gender equity and human rights more broadly.


Thus, the SDG 10 includes two targets that need to be considered in drug policy: 

10.2 By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status;

10.3 Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.

Brazil has a very advanced recent experience of response to problematic contexts of drug use for people living in social exclusion, such as the Open Arms Program, an action of the São Paulo City Hall dedicated to the assistance to drug addicts that focus in the area of Luz in the town. The intersectoral action, which gathers health, work, shelter and food, has been shown, according to studies, that there was improvement in quality of life indicators of program participants as well as a considerable reduction in the use of crack.

Another Brazilian initiative, which seems to be very promising in this direction, the REDES project, which is an initiative of SENAD/MJ in partnership with the Oswaldo Cruz Foundation (Fiocruz), the technical area of Mental Health of the Ministry of Health and the Ministry Social Development. This action aims to promote a growing proximity between health policies, prevention, safety, security and social inclusion.

The aim is to develop methods of integration between public policies of municipalities through the establishment of shared management forums, dialogue channels, meeting places between professionals from different networks to discuss and permanently evaluate the forms of prevention, promotion and health care, inclusion and citizenship of people with drug-related problems.

Under the REDES Project, the SENAD/MJ has funded a number of innovative efforts to promote the social reintegration of drug users in extreme vulnerability. The projects combine housing actions, professional training, reintegration into the labor market and social support for cooperative activities.

In other words, Brazil has been developing well-aligned actions with international guidelines regarding drug policy and they need to move forward and be extended to the entire national territory.


Good health and well-being

Ensure healthy lives and promote well-being for all at all ages

SDG 3 (ensure healthy lives and promote well-being for all at all ages) explicitly includes strengthening the prevention and treatment of substance abuse. Programs aimed at prevention, treatment, care, rehabilitation and social reintegration play a key role and, based on evidence, can reduce the negative health and social impacts related to problematic drug use.

The investment in evidence-based programs represents an effective response. It is noteworthy that, in the field of prevention, Brazil is investing in evidence-based programs aligned with International Guidelines on Drug Use Prevention. Since 2013, in partnership with UNODC, the Ministry of Health (MS) has identified three programs that, in international scientific literature, have shown results related to delay and avoid the first use of psychoactive substances, in addition to reducing the level of alcohol abuse, tobacco and other drugs among the audience they target. Currently, SENAD has also supported the implementation of the three programs:  ‪#‎Tamojunto, Jogo Elos and Famílias Fortes.

Apart from problems associated with using as the risk of overdose, suicide, development of mental disorders, it is necessary to consider that people who make the injectable use are more vulnerable in relation to HIV and viral hepatitis transmission as well as face greater difficulty in accessing the services due to the stigmatization and prejudice regarding the use of drugs. In Brazil, a study conducted by Fiocruz showed that people who use crack and/or similar drugs have an HIV prevalence rate eight times higher than the general population.

Hence, beyond the direct relationship between injecting drug use in unsafe way and the transmission of HIV or hepatitis C, studies have shown that it must be considered the greatest vulnerability of people who make use of stimulants such as cocaine and amphetamines and its relationship with unprotected sex.

When policies are not aligned with principles of international conventions for drug control, they can weaken the accessibility of drugs controlled both for medicinal purposes and for research. Three quarters of the global population still lack access to medicines containing narcotic drugs and has inadequate treatment to handle moderate to severe pain. The importance of provision of essential medicines, which typically include controlled drugs, was recognized in target 3.b of the SDGs.


Gender equality 

Achieve gender equality and empower all women and girls

The SDG 5 (achieve gender equality and empower all women and girls) points to the need for drug policies to recognize that there are important differences between men and women who use drugs in relation to usage patterns and also the associated vulnerabilities . Due to the male predominance in the use of certain types of drugs, there is the risk that the care network can not meet the specific demands of women who use drugs, representing obstacles in access to services.

Women in drug addiction situation and living with HIV are usually more vulnerable and stigmatized than men. These women are more likely to have been victims of violence and abuse, particularly domestic violence. In this regard, it is worth mentioning one more data from research carried out by Fiocruz among crack users and / or similar, in which the proportion of women who reported having suffered sexual violence at least once in life was six times higher than that reported by men (respectively, 46.63% and 7.49%). This demonstrates the need and challenge for countries, including Brazil, to develop policies and actions that include the gender perspective.

Female offenders, especially the ones with some disorder related to drug use, face various difficulties in the criminal justice system since these systems usually are not properly equipped to meet their specific requirements.


No poverty

End poverty in all its forms everywhere

Drug use typically affects people during their most productive years, harming their development and their communities. The drug problem affects, even though in different ways, both developed and developing countries. Which brings us to the SDG 1 (end poverty in all its forms everywhere).

The connection between economic development and drugs is particularly evident in the case of illicit drug cultivation. In rural locations, socioeconomic elements like poverty and the lack of a sustainable livelihood culture are risk factors that lead farmers to engage in illicit cultivation, which is also a manifestation of poor levels of development related to security and governance.


Peace and justice

Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable institutions at all levels

SDG 16 (promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable institutions at all levels).

This goal relates primarily to the efforts to strengthen the rule of law and access to justice and combating corruption and organized crime. Drug use triggers different levels of violence related to its psychoactive effect or as a means in order to obtain resources for their purchase.

Regarding access to justice in Brazil it is important to point out the challenge of access to justice for women, according to the Ministry of Justice's report on women prisoners. In the period 2000-2014 the increase of the female population was 567.4%, while the average male growth in the same period was 220.20%, reflecting thus the upward curve of incarceration mass of women. They are young women, have children, are responsible for the provision of family support, have low education, come from an economically disadvantaged social strata and perform informal work activities in the period prior to imprisonment.

Around 68% of these women have criminal ties for involvement in drug trafficking unrelated to larger networks of criminal organizations. It is essential, therefore, that the challenge of drug policy in Brazil and the region addresses a gender perspective.

It should be also be noted the recent decision of the Federal Supreme Court (STF) to withdraw the heinous nature of the conviction of two men convicted of drug trafficking for being first time offenders, have a good record, not devoted to crime or were part of a criminal organization. This decision will certainly have future impact on the issue of prison overcrowding caused by penalties that have been considered, including by the STF ministers as "disproportionate" in relation to small dealers conduct, especially women.

2014 data from the Ministry of Justice indicate in the country a prison population of 622,202 people, of which 174,216 (28%) were convicted of crimes related to drugs. 


Partnership for the Goals

Strength the means of implementation and revitalize the global partnership for sustainable development

SDG 17 (strength the means of implementation and revitalize the global partnership for sustainable development). This goal has a strong relationship with the principles of international cooperation and shared responsibilities, incorporated in the drug control conventions. However, while official development assistance has increased, assistance to sectors related to drugs has declined significantly since 2008. Efforts to eliminate illicit cultivation might impact income sources and employment opportunities for farmers. Research shows that these efforts will only have a positive impact if they include development measures that ensure alternative livelihoods and restore security and force of law.

Interventions that aim to strengthen the influence of the law, the foundation of sustainable development, can influence the availability of drugs on the illicit market by reducing the supply through interdiction and increasing the risk for traffickers. This leads to a price increase in consumer markets. However, this can lead to violence, especially when they affect the internal and external structures of these illegal markets. These efforts must be thought of long-term and targeted to all the actors and elements of drug trafficking, since otherwise, may lead to increased violence. Prevention, early intervention, rehabilitation, care and social integration measures for drug users, based on scientific evidence, reduce drug use and its effects on public health, one of the most important components of the well-being of society. These benefits affect both users and society in general, proving to be effective in preventing HIV and viral hepatitis.

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