Inclusive health policy and harm reduction

In the “Socio- sanitary solutions, experiences and challenges” panel , Andrea Gonzalez stressed that the illegality of drugs prevents any accurate or abundant information about their effects. Di Nella Yago stressed that health policy should stop excluding drug users and vulnerable populations in general, Giselle Amador Muñoz questioned the policies of his country (Costa Rica), Laura Guzman discusses the experience of crack users , and Maria Elena Ramos spoke on harm reduction.

(Mexico City, September 14, 3:00 pm) Comprehensive care of drug users implies developing comprehensive strategies, complementary and not which address prevention, drug addiction assistance, harm reduction and social integration. Surrounding this concept ideas and experiences where shared by representatives of Mexico, Argentina, USA and Costa Rica as part of the “Socio- sanitary solutions, experiences and challenges” panel.

Andrea Gonzalez, Program coordinator of the HIV / AIDS program in Mexico City and director of the Specialized Clinic Condesa in Mexico City, said that “the State program reads ‘reduce illegal drug use among 12 and 17 year olds, that is they are contained in a health program for a limited term. Health policy in Mexico has no health perspective. “

After explaining that the drug war in Mexico has a very high mortality rate, which exceeds deaths due to HIV and drug abuse, she asked: “Specifically, what in the terms of consumption resolves this war?”

Finally he said that the consequence of the illegality is the little and false information on issues related to drugs, especially the issue on crack. “This illegality prevents needle exchange programs and other harm reduction strategies,” he said.

In turn, the national director of Mental Health and Addictions of the Ministry of Health of Argentina, Yago Di Nella, commented that the law of the Mental Health of this country, of recent sanction, establishes that the medical treatment for drug dependents (legal or illegal) like a right for all and that it is working to implement this mandate.

“For every nine people with alcohol problems in Argentina, one person has it with illicit drugs. However, the previous budget was reverse logic: the epidemiology noted that the main problem is alcohol, but much more was spent on illegal drugs,” said Di Nella, who emphasized that health policies need to stop being exclusive with drug users and vulnerable populations such as people deprived of their freedom.

In line with the statements by her colleagues, the coordinator of the Master in Drugs of the University of Costa Rica, Giselle Amador Muñoz, said three million people require treatment for problematic alcohol use in contrast to 34 thousand for the problematic use of illicit substances.

She criticized the weakening of the budgets for the care of mental health problems in their country and gave an example of the limitations that there are only nine Service Centers specialized in drug issues and that there should be at least 20 of these places.

“The drug policy in Costa Rica is allied with the War on Drugs, it adds to the current president,” she said, and mentioned a survey in which asked the situations of insecurity perceived by the population: the two largest responses were that insecurity is related to drug use and the presence of “crackeros”. “This view is fueled by the media, government policies and lack of differentiation between drug trafficking, drug dealing and consumption. In Costa Rica, possession for consumption is not penalized, but from 2006 to 2009 increased the detention of people,” he concluded.

Later, Laura Guzman, Director of Resource Center of Mission San Francisco, trainer of the American Coalition for Harm Reduction Association (IHRA), USA, referred specifically to the crack users and had some cases and user testimonials. One of them consumed to forget about family problems, another spent three days in a coma and did not know his name. According to the panelist, one of the factors that make it more harmful to crack is the aggregates that are made.

Finally, Maria Elena Ramos, director of Program Partners, Ciudad Juárez, Mexico, rescued the fact that 25 years ago nothing was done to address these problems, while today there are several organizations working in harm reduction.

She said that, while still arresting users who carry syringes, this happens less than in the past. “The violence has made us rethink the approach strategies and have a major expense, because the police are carrying the containers as evidence of consumption. It has reduced the number of treatment centers not only in Juárez but the entire country,” she said.

In reference to drug users, affirmed that in many cases “living in marginalization, they have serious health problems, they have abscesses, they have STIs, overdose deaths, several family members use drugs. The family has a history of consumption, violation of human rights, extreme poverty and gender violence. Women who inject drugs and their situations are more pressing.”