What do you think of the Vienna Declaration?

[oryxandcake]

Drug policy has had a significant influence on how health care providers attend to the needs of patients with addictions and co-related illnesses (HIV, Hep C, mental illness). While addiction is considered to be a bona fide illness - stigma related to morality and politics have largely dictated treatment and also, have influenced public perception of those ill. Illicit substance use is largely underground and in many areas, users share paraphernalia. It is also well documented that they engage in other risky behaviors and are less likely to engage with the health care system - reducing their chances of prevention, early intervention and treatment.

The International Aids conference in Vienna next week has created a declaration created by experts in HIV/AIDs - is asking the public to think about this statement: "The criminalization of illicit drugs users is fueling by the HIV epidemic and has resulted in overwhelmingly negative health and social consequences. A full policy reorientation is needed." And if you agree, to sign their declaration.

Anyhow - I am interested in what you guys think. Do you agree with the above comment? Have you had different experiences?

[mamamerlee, LPN]

I have read this 4 times, and I'm still not sure what they are getting at. That we decriminalize the drugs? The users? Provide clean needles? What are the PLANS?

The fact is, there have always been, and always will be, some element of society that lives outside of the mainstream no matter how we try to help them. And it seems like no matter what is done to provide them with optimal care, they are not capable of accepting the care that is offered.

Show me the plans.

[oryxandcake]

I have read this 4 times, and I'm still not sure what they are getting at. That we decriminalize the drugs? The users? Provide clean needles? What are the PLANS?

The fact is, there have always been, and always will be, some element of society that lives outside of the mainstream no matter how we try to help them. And it seems like no matter what is done to provide them with optimal care, they are not capable of accepting the care that is offered.

Show me the plans.

The declaration is an actual statement that is asking for recognition that criminalization of drug use has perpetuated HIV epidemic and thereby, causing health and social harm. It is not a plan in itself - but what it is asking for after the statement - a concentrated effort to create effective policy, most likely with the intent of decriminalizing illicit drug use in attempt to reduce the harms it has caused.

Criminalizing drug use leads to people using drugs away from the mainstream thereby marginalizing the persons - which is harmful in itself. Additionally, HIV and Hep C are commonly spread throughout the jail systems when research shows harm reduction policies have effectively reduced the spread of both diseases.

Overall, policies have been half baked - created to please voters, dismissing current research. The war on drugs for example, has been shown to be a significant failure; drug use has increased in parallel with social inequities.

Decriminalization is focused on reducing barriers - financial, social and health related. They (Vienna Group) argue that drug users should be treated for their health problems, not treated as criminals. Again, this goes along with recognizing that addiction is a disease - not a moral issue, not a choice. The initial use may have been a choice, but there a physiological processes that drive addiction. The goal would be to provide treatment for drug use like what has been done for tobacco and alcohol addiction.

Also the attitude that "they are not capable of accepting care that is offered" is extremely paternalistic and dismissive. Health care is best delivered when the health care providers works with the person, not over the person.

[gentlegiver, ASN, LPN, RN]

I work LTC/Rehab, over the last few months we have admitted 4 or 5 patients with drug addictions. My job is to treat thier illness' that brought them to my unit. Sad to say we have had a couple who after discharge went right back to thier old ways and ended up on my unit again. We do not treat them as criminals, we treat them as people with health issues. While I agree that this is the way they should be treated, legalizing drugs would not help the situation. I wish that once done at my facility, these people could go to a drug rehab. But that is not possible unless they want to go, you can lead a horse to water.....

[oryxandcake]

i work ltc/rehab, over the last few months we have admitted 4 or 5 patients with drug addictions. my job is to treat thier illness' that brought them to my unit. sad to say we have had a couple who after discharge went right back to thier old ways and ended up on my unit again. we do not treat them as criminals, we treat them as people with health issues. while i agree that this is the way they should be treated, legalizing drugs would not help the situation. i wish that once done at my facility, these people could go to a drug rehab. but that is not possible unless they want to go, you can lead a horse to water.....

decriminalization is not the same as legalizing. decriminalization refers to no longer making it a crime to use drugs; however, regulations would still be in place for people who use. legalization on the other hands means that all legal restraints would be removed. in this case, the vienna declaration is asking for a public health approach that recognizes that primary use of law enforcement has been ineffective in reducing drug use and other policies need to be created to address the problem; policies which aren't political motivated - that are health focused.

from the vienna declaration website: "the need for evidence-based public health approaches is clear, yet drug law enforcement continues to be the dominant policy approach at the expense of all others, including public health interventions that have been proven effective. for instance, methadone maintenance therapy remains illegal in russia and other parts of the world where hiv is spreading most rapidly among heroin users. this ban persists despite the fact that methadone is on the world health organization's list of essential medicines and is recognized as one of the most effective treatments for heroin addiction"

[gentlegiver, ASN, LPN, RN]

Decriminalization is not the same as legalizing. Decriminalization refers to no longer making it a crime to use drugs; however, regulations would still be in place for people who use. Legalization on the other hands means that all legal restraints would be removed. "

If it is no longer a crime, doesn't that make it legal?? I can't seem to wrap my brain around this one.

[dudette10, MSN, RN]

If it is no longer a crime, doesn't that make it legal?? I can't seem to wrap my brain around this one.

I googled around a bit, and the difference seems to be punishment vs. regulation. Drug users are "criminalized" in that they become criminals if caught...court, jail, etc.

If I understand it correctly, a good example of decriminalization would be alcohol. Prohibition criminalized alcohol, while the end of prohibition decriminalized (but still regulated) it. Alcohol is regulated, and there are certain things you can and can't do while intoxicated. You can't drive, you can't create a ruckus, you can't sell to minors, minors can't consume, etc. Sellers and manufacturers are also regulated.

[dudette10, MSN, RN]

Eh, screw it. I didn't understand it. Found this as I googled.

Decriminalization:

A system that punishes offenses by means other than prison. Fines for most traffic violations are an example. In relation to drugs, it is normally limited to possession (and sometimes growth) of small amounts (often around one ounce) and somtimes to sale of equally small amounts to adults. It is also often limited to marijuana among the illegal drugs.

There is another distinction possible between de jure decriminalization, which entails an amendment to criminal legislation, and de facto decriminalization, which involves an administrative decision not to prosecute acts that nonetheless remain subject to arrest and imprisonment under the law. Some cities have simply decided de facto to specify that enforcement of some marijuana laws is the "lowest priority" for their police forces.

Legalization:

A system that allows the use and sale of drugs to adults under a system of regulation such as pertains to alcohol or perhaps involving licenses. Many suggest there would be a ban on advertising and public use. If the alcohol model prevailed, different states might vary the regulatory structure and legality might also be limited by local option to specific areas within a state.

Even after reading that, I don't know what "decriminalizing" drugs would practically look like. Using a traffic violation as an example of "decriminalization" seems weird.