The Global Commission calls for decriminalization as key to addressing the opioid epidemic in North America


Wednesday 1 November 2017

The current opioid epidemic that is sweeping across North America urgently requires a balanced and responsible legal framework for managing the presence of drugs in society.

Authorities initially responded to the crisis by limiting the supply of prescription opioids from health care providers. Evidence shows, however, that most cases of drug dependency are now fueled by the misuse of these substances rather than by legal prescriptions written for patients who are being treated for pain.

People who have become addicted to opioids therefore find themselves without effective support systems, such as treatment or harm reduction services. To avoid suffering withdrawal symptoms, they turn to the illegal market for prescription opioids, and some shift to heroin. This has contributed to the exponential rise in drug overdose deaths.

Yet the harm reduction and treatment measures needed to address this overdose epidemic exist for the most part—and are well known. There is ample evidence of their efficiency based on years of implementation in other countries where drug control policies are more focused on the rights and needs of individuals.

These measures include needle and syringe programs, safe injection facilities, the availability of opioid overdose reversal medication such as naloxone, drug checking, opioid substitution therapy, and heroin-assisted treatment, as well as services for social and professional reintegration.

However, what appears to be lacking, primarily in the US, are the will and political commitment to conduct the required changes in drug policies that would allow these services to be implemented, improved and expanded upon. These changes would also remove the stigma and discrimination too often associated with drug use after decades of prohibitionist policies.

Only by decriminalizing the consumption of drugs and their possession for personal use can people in need of health and human services access these services easily, and without fear of legal coercion or social exclusion. In the absence of reforms at the federal level, city, county or State/Provincial authorities – who are closer to the constituencies most afflicted by the epidemic – should consider de facto decriminalization at their levels.

It has become even more urgent to implement treatment services and harm reduction measures in light of the growing presence of fentanyl in heroin sold on the illegal market. Fentanyl is a highly potent synthetic opioid, which is now a major contributor to drug-related overdose deaths.

For these reasons, the Global Commission on Drug Policy reiterates the recommendation outlined in its Position Paper on the Opioid Crisis in North America published on 2 October to “allow and promote pilot projects for the responsible legal regulation of currently illicit drugs including opioids, to replace and bypass criminal organizations that drive and benefit from the current black market.”