Conclusions and Perspectives

With more than 450 people in attendance, the VI National Conference on Drug Policy, organized by INTERCAMBIOS Civil Association, was held on August 25th and 26th in Buenos Aires in the Auditorium of the Honorable Chamber of Deputies of the Nation. In the opening session of the conference, the Minister of Justice, Security, and Human Rights, Aníbal Fernández, declared, “Last year, we came to this conference to announce the depenalization of drug possession for personal use. Today have advances to show. The next step is the implementation of a general harm reduction policy.”

For the sixth consecutive year, the National Conference on Drug Policy was held in an auditorium of the National Congress, and was attended by legislators, judges, policy makers, professionals from the judicial system and health institutions, representatives of NGOs, and drug users. Declared of interest by the Honorable Chambers of Deputies and Senators of the Nation and declared of legislative interest by the Legislature of the City of Buenos Aires, the conference was made possible by support from the Global Drug Policy Program of the Open Society Institute.

INTERCAMBIOS Civil Association is a non-governmental organization that has been working on the study of and attention to drug-related problems for thirteen years. This conference is considered an effective mechanism for the gathering of decision makers, policy makers, researchers, and members of civil society with the goal of improving current drug policies by increasing their efficacy, viability, and credibility.

During the opening session of the conference, Graciela Touzé, President of Intercambios, explained that, when they started to organize the National Conferences on Drug Policy in 2003, Intercambios was trying to initiate a debate on drug control policies, the rights of drug users, and the health system. She warned, “Today, this debate is established, but this does not excuse us from demanding that it moves forward based on scientific evidence and within a more complete human rights framework.”

The specialist stated that there is a need to strengthen a work agenda that also thinks about “how to clarify the confusion among opponents of depenalization that equate it with drug legalization,” such as proposing projects that combine “the depenalization of drug possession for personal use with systems of social protection.”

Moreover, she suggested that “there is no doubt that topics such as the international drug trade, the control of chemical precursors, or the investigation of money laundering require multisectoral action and a logic of regional work.”

Touzé concluded, “We insist on the definitive incorporation of harm reduction strategies into the repertoire of prevention and assistance interventions promoted through public policy.”

Shortly afterwards, Minister of Justice, Aníbal Fernández, spoke along the same line: “Drug policy in this government has a course: repression of drug trafficking, prevention, and, if the police find a child in a situation of problematic drug use, they do not take him to the police station but to the hospital where they know how to attend to him with a strong policy of harm reduction.”

The opening session also included the Vice Minister of Health, Juan Carlos Nadalich; the Coordinator of the Scientific Advisory Committee on the Control of Illicit Narcotic Trafficking, Psychotropic Substances, and Organized Crime, Mónica Cuñarro; the General Director of International Drug Affairs of the Ministry of Foreign Relations, Ricardo Carlos Roselli; and Deputy Graciela Giannettasio, President of the Commission on Addiction Prevention and Drug Trafficking Control of the Chamber of Deputies of the Nation.

Giannettasio referenced the debate over chemical precursors: “If we now have a new enemy known as “the precursor,” it will not be resolved through prohibition or legislation. The state must carry out controls on a regular basis. Only the Ministries of Health and Economics supervise the legal production of precursors, and taxes will play a big part in this without the need of criminal persecution.”

A context for a phenomenon?

In the first panel moderated by Pablo Cymerman, “Sociocultural Context of the Phenomenon of Drugs”, certain discussants problematized the title of the panel in order to illustrate that drug use is not a “phenomenon”, with a “context” but “a sociocultural process”, as indicated by Alicia Stolkiner, Professor of Public Health/Mental Health in the School of Psychology at the University of Buenos Aires.

Stolkiner suggested that “the main focus on the drug user is the most concealing of all” because it omits the existence of 1) a sub-group of people deprived of their rights; 2) institutions fighting against the problem that usually become part of the problem, and 3) an anti-drug war that is a fundamental tool for government corruption. She affirmed, “Once the Cold War ended, drugs became a way of constructing an enemy, especially in Latin America”.

“Neither phenomenon nor context,” started Patricia Digilio, specialist in Planning and Management of Social Policies and Master of Social Policies. She emphasized how words construct meaning in order to demonstrate that “social policies should not be oriented toward that abstraction called “social problems,” but toward people with a history; not beneficiaries, not clients, not users, but citizens with rights and who are autonomous.” But, she warned, “The recognition of this autonomy must not be interpreted as a semi-democratic alibi that transforms political responsibilities into individual responsibilities.”

In his speech, psychologist Daniel Korinfeld, Master in Community Mental Health and Co-Director of Punto Seguido, focused on the role of the school as a place where the polemic regarding the ways of approaching the drug problem has still not entered. He said, “The focus on harm reduction is a good way of initiating the debate by giving the subjects and the policy a place within the debate. It also offers concrete activities. Above all, it provides a good space for children and teens to talk, and no one knows what children and teens think on the subject.”

Sebastián Basalo, the director of THC, Argentina’s only publication on cannabis culture, proposed that the “depenalization of drug possession for personal use is part of the problem. But, the lack of a good health system and prevention campaigns are also part of the problem. Hundreds of youth with problematic use are waiting to be attended to; others are detained for cultivating two marijuana plants; others lose their jobs for having prior convictions for smoking a joint.”

Finally, sociologist Pablo Alabarces, independent researcher at CONICET, explained that “for youth, drinking and smoking whatever comes along demonstrates, in a certain context, that he or she has endurance.” And this, by constituting a morality in contrast with what is considered hegemonic, demonstrates the hypocrisy of the dominant system: “And doing so shows us, in spite of itself, a pluralism of moral systems that we should understand.”

With their own voice

In the panel entitled, “Approaches to Policy Based on Evidence and Human Rights,” drug user and user rights activist, Edith Moreno, served as a panelist. Ms. Moreno, President of the Córdoba-based organization, Cogollos, defended the right of drug users to have their voice heard “in those spaces where policies on the topic are defined.” Moreno also proposed that “the use of cannabis be treated as the tobacco law and that it is a big lie that marijuana is a drug that initiates the use of other drugs.”

With Diego Santillán of INTERCAMBIOS Civil Association serving as moderator, the panel also included María Epele, Doctor of Anthropology and researcher at CONICET, who proposed that the difference in perceptions on the topic between health professionals and drug users creates a barrier in accessing the health system and generates “relationships colored by distrust, a product of decades of criminalization.”

Epele affirmed, “Users are not outside of the health system because they want to be self-destructive. Rather, this type of barrier is located in the geographic, the symbolic, and the corporal. The indistinction between the health system, the judicial system, and the police system leads to healthcare being delivered in a judicial and police framework.”

Finally, sociologist Ana María Mendes Diz, researcher at the Gino Germani Institute at the University of Buenos Aires, and Dr. Marcelo Vila, HIV/AIDS Consultant for the PAHO/WHO and researcher at INTERCAMBIOS Civil Association, presented the results of research related to drug users and their vulnerability to disease transmission.

The study carried about by the Gino Germani Institute entitled, “Drug Users and HIV Transmission Risk,” revealed that drug users that participate in harm reduction programs engage in more care practices; have more information; and are less homophobic or discriminating toward others than those that do not participate in such programs.

In the case of the three studies presented by Vila, similarities were found with respect to the different factors that cause vulnerability among users in different cities in Argentina, Brazil, and Uruguay.

Vila concluded, “Disease transmission is related to cultural, religious, and many times juridical factors. Because of this, some public policies regarding drugs and sexual and reproductive health can also be contributing to the spread of HIV.”

Drugs, Democracy, and Human Rights

The final presentation of the first day was given by Coletta Youngers, Master of Public Affairs and director of the project, “Drugs, Democracy, and Human Rights” at the Washington Office on Latin America (WOLA), and focused on the topics of “drugs, democracy, and human rights in Latin America.”

“With the end of the Cold War, the War on Drugs emerged as a way of maintaining the United States’ presence in Latin America,” explained Youngers in an effort to historicize the anti-drug trafficking policy of the United States. She recalled that Plan Colombia began in 2000, an operation in which more than six billion dollars was assigned to Colombian armed forces and poppy fumigation policies. She added, “The United Nations, nonetheless, just announced last June that the amount of coca cultivated in 2007 increased by 27 percent in comparison to 2006.”

Regarding the situation in the interior of the United States, Youngers commented, “In my country, the United States, a policy against drugs is a policy against the poor.”

To conclude, Youngers explained, “Much of my analysis has to do with what was published in 2005 in a book on human rights and anti-drug policy, and almost everything we said continues to be true. But, there is something that has changed: in various Latin American countries, there have been select governments that have proposed alternative policies, such as Bolivia, Ecuador, Brazil, Uruguay, and Argentina. This opens up a new panorama.”

Laws That Are Excessive… Or Not Enough

On the morning of Tuesday, 26 August, the opening panel moderated by Alejandro Corda from INTERCAMBIOS Civil Association was entitled, “A Necessary Revision” and focused on national drug legislation. The panelists spoke of a common issue: there is a lot of punitive legislation against drug users, but there is very little in terms of regulating the drug supply.

“From a legislative point of view, there is an erratic concept with respect to the drug law, and, until 2007, there is not just one directionality. The norm should be to set clear, not arbitrary, limits in its application,” opened national legislator, Graciela Giannettasio, President of the Commission for Addiction Prevention and Drug Trafficking Control of the Chamber of Deputies.

Giannettasio declared, “We have been working with the different existing criteria to find a clear text that, in accordance with our national and international commitments, will protect drug users forever.”

In this speech, Leonardo Gorbacz, legislator from Tierra del Fuego and fellow member of the Deputies Commission, stated that “possession is an excuse for imposing coercive measures that are selective. Today, we have a new situation because the Ministry of Justice and the Presidency of the Nation have come to an agreement to not persecute addicts. We have to move toward another policy and modify the drug law in order to not penalize people that use drugs.”

The panel also included the National Senator for the City of Buenos Aires, Samuel Cabanchik, member of the Ombudsman Commission of the High Chamber, who stated, “There are two conflicting discourses: the repressive discourse that has come from repressive legislation and the emancipatory discourse that transforms the user into a hero. The growing tendency toward a policy guided by harm reduction can overcome that opposition.”

At the end of the panel, Horacio Cattani, Judge in the National Chamber of Criminal and Federal Correction Appeals warned, “There is a need to realize that imprisonment destroys the life of a drug user. We need social policies, and we need to update administrative and health legislation: the Medication Law was passed in 1964; the Narcotics Law was passed in 1968; and the Psychotropic Law was passed in 1971. With penal law at the forefront, we have many problems.”

From the State: Prevention and Treatment

What policies are used at the state level? In order to review public experiences with drugs, a panel was held entitled, “Socio-health Policies: A Question of Access to Care.” With Diana Rossi, member of INTERCAMBIOS Civil Association, serving as the panel’s moderator, the Sub-secretary of Community Health of the National Ministry of Health presented his work in the field of addictions. “We are organizing working groups in different provinces with the objective of perfecting the healthcare network,” explained Aldo Domanico, the person in charge of this area. He also pointed out that that “the persecution of drug users keeps them from coming to the hospital. They only come when they are doing really bad, and many doctors do not know how to attend to them in these situations.”

In the Province of Buenos Aires, Alfredo Macrade, Provincial Director of the Sub-secretary of Addiction Assistance of the Ministry of Health, spoke about the province’s more than 100 Addiction Prevention Centers (CPA). He said, “We realized that the classic criteria for geographic accessibility could not be achieved. And we added the idea of accessibility to the social imaginary because of the stigma associated with providing care for addiction. Today, in the Province of Buenos Aires, a public-private system operates with respect to hospitalization; 50% can be attended to in the public network, and another 50% at a private NGO.”

Gracia Nuesch, General Director of the Coordination of Social Policy on Addiction of the Ministry of Social Development of the Government of Buenos Aires, presented on the first steps of the implementation of Law 2,318 regarding “Prevention and Care for Psychoactive Substances Use and Other Risk Practices,” which has been in force since December 2007. “The decision of remaining under the control of the Ministry of Social Development has to do with understanding psychoactive drug use as a health, education, work, juridical, and economic problem, and it is, fundamentally, a social problem,” she explained. “The most consumed drug continues to be alcohol (65.7%) while cocaine paste base is the least consumed (0.57%),” she added.

In her speech, Laura Inés Lonatti, Coordinator of Self-Managed Experiences of the National Ministry of Social Development, explained that the initiative, “Opening Paths: Alternative Strategies in Addiction Prevention,” has as its objective the strengthening of all spaces of community organizing. She pointed out, “We are trying to reconstruct spaces for meeting, consensus, and debate through open lectures where we try to construct multi-actor spaces. And they are urgent spaces because fragmentation in the field is very high. The state has a primordial commitment to the organized neighborhood. We think that the best factor of protection is constructing those bonds again.”

Finally, María Pía Pawlowicz, Master in Social Science and Health and researcher at INTERCAMBIOS Civil Association, presented a qualitative-quantitative study involving the administration of questionnaires to health professionals in order to identify the barriers drug users face in accessing hospital care. She stated, “The proposals of those that attend to drug users in public hospitals in Buenos Aires and Rosario are centered on the need to create a relationship between health services and multisector services, such as increasing extra-hospital interventions and improving care mechanisms.”

When the Answers Come from the Field

What happens during community work, that work which is carried out in the field? These experiences were shared in the panel, “Possibilities and Limits of Fieldwork,” moderated by Araceli Galante from INTERCAMBIOS Civil Association.

The change in the profile of the drug-using population was a common theme of all the presentations. From the Santa Clara de Asís Therapeutic Community, General Director Fabián Chiosso explained, “Since 1996, we have worked primarily with adult men. But, since 2001, we have come across a large number of children and teens, and there have started to be more women with drug problems.” Chiosso showed that these factors require a change in the work design, orienting it much more toward education: “The central experience is the school. Today, we have a school inside the therapeutic community. But, what we most emphasize is providing a child with all the necessary social skills they need for not becoming a ‘problem child’ at school.”

In the case of the “The Other Base of Encounter” Day Center, a center connected to Piñero Hospital in the City of Buenos Aires, social work Eduardo Bogliano proposed that the current challenge in the health system is “to eliminate prejudices; to train ourselves; to have detoxification beds in a hospital in the City of Buenos Aires; and to integrate this work into everything that is coming from other environments. Our care mechanisms are framed in a harm reduction paradigm and a type of participative methodology.”

In his speech, Alexis Medina, social worker and member of the in La Matanza-based El Coihue Asociación Civil in the Province of Buenos Aires, urged those present to “revalue the knowledge that is in the neighborhoods” and he discussed the positives of working with harm reduction “because it allows one to think step by step and to not stigmatize; but it also says to a person that they are going through a situation of using, but there are many ways that we can think collective.”

Speaking of the experience of the Lomas de Zamora -based “Health, HIV, and Drugs - Join Me” Counseling Group of the Luisa C. De Gandulfo Hospital in the Province of Buenos Aires, social worker Alicia Salman stated “how the appearance of new proposals from the national government is an opportunity to incorporate more harm reduction strategies.”

Finally, social worker Julia Recchi from the community intervention division of INTERCAMBIOS Civil Association talked about the “Locos de Avellaneda” intervention with a position that was shared by almost all the panelists: “1) to acknowledge that the street is a privileged space for intervention; 2) to implement friendly services in the territories where we work; and 3) to develop a form of training and work supervision. Working in situations of social vulnerability consists of creating spaces of social integration.”

Ten Years Since UNGASS

In 1998, the United Nations dedicated a Special Session to the topic of drugs (UNGASS). In that session, ratified commitments for members states were generated that would be evaluated and redefined in the next session in 2009. To present how different Latin American countries will act at UNGASS 2009, a panel was held on the revision of the goals of the United Nations Special Session on Drugs (UNGASS), and was moderated by Gonzalo Ralón of INTERCAMBIOS Civil Association.

The first to present was Milton Romani Gerner, General Secretary of the National Drugs Committee of the Presidency of Uruguay. He discussed the process by which a consensus was achieved that allowed for the approval of a declaration presented by the Uruguayan government at the 51st Narcotics Session in Vienna in March 2008. The declaration recommended “the proper integration of the United Nations harm rights system with international drug control policy.” This text was co-sponsored by Bolivia, Argentina, Switzerland, and eventually by all of the European Union.

Romani stated, “Constructing policies for UNGASS is becoming essential. It is not easy to achieve an equilibrium between the legitimate exercise of state coercion and the respect of human rights. There is a risk of turning the topic into a crusade similar to the Inquisition.”

Regina Bueno of the Brazilian Harm Reduction and Human Rights Network (REDUC) and Denis Petuco of the Brazilian Harm Reductionist Association (ABORDA) presented a joint report that elaborated on these reflections with regard to the Brazilian government: “The new drug law in Brazil, although it means an a move forward and it has a preventative rhetoric, continues to have a repressive emphasis.”

International Analyst on drugs, security, and the Amazon, Ricardo Soberón, explained that “despite the assumed political commitments, invested money, and actions carried out in the world, the coca production industry continues to be a world business coming from the south; that takes advantage of two million poor producers and fourteen million under-privileged drug users; and generates the profound effects of corruption and violence.”

The panel ended with a presentation by Graciela Touzé, President of INTERCAMBIOS Civil Association, who called upon NGOs to get involved in the UNGASS process “because we politically influence our national delegations. We Latin American activists are firmly committed to including our agenda and to influencing this process.”

At the end of the conference, Graciela Touzé emphasized the advance in the vision of harm reduction as “a proposal based on scientific evidence that allows for the drawing closer of a range of concrete answers to drug-related problems.” She particularly saluted the depth and quality of arguments of the debates maintained during the VI Conference which drew closer a consensus between different actors in terms of the harms produced by the penalization of drug possession for personal use. Finally, she mentioned that, when the VII National Conference on Drug Policy is held in 2009, the UNGASS results will open up new perspectives on what will be the international drug policy for the coming years.