‘Cautious welcome’ as Drug Master Plan puts harm reduction on SA agenda

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The umbrella activist organisation South African Network of People Who Use Drugs (SANPUD) has “cautiously welcomed” the government’s National Drug Master Plan despite its flaws, “as a necessary shift to get harm reduction on the political agenda”, reports MedicalBrief.

In a statement, SANPUD said it was discouraged by several issues in the document, which compromised it. There were “mixed messages, factual inaccuracies, contradictions, a lack of indicators specifically related to the provision of essential harm reduction services”. These had been in earlier versions of the plan “but appear to have been removed”.

SANPUD said that the new plan contradicted existing SA Police Service policies, as well as the Constitutional Court judgment on cannabis usage

“Sections that promote a very biomedical understanding of drug use detract from the message of inequity and lack of opportunity as a driver for drug dependence, and there is the risk of over-pathologisation. The belief that people who are dependent on unregulated drugs have a chronic disease of the brain can result in forced treatment, compromises to individual autonomy and the idea that people can resolve drug issues only through expensive treatment systems. The data suggests that instead when peoples’ circumstances improve, their drug use decreases,” said Shaun Shelly, SANPUD chair.

“The undue attention to novel psychoactive substances does not speak to the reality on the ground. Except for synthetic cannabinoids, there have been few of these available in South Africa.

“Similarly, the discussion on online drug markets is misplaced. It appears as if these inclusions are more to satisfy external rather than internal interests,” Shelly said.

“The police indicators that include numbers of arrests are not evidence-based or appropriate. They contradict the first principle of effective policing, which states that the effectiveness of the police is not measured by the number of arrests, but by the absence of crime.”

Shelley said that the SA police annual performance plan contradicted the National Drug Master Plan and the Constitutional Court judgment on cannabis. A critical issue not adequately addressed was how the Central Drug Authority (CDA) would be funded and be afforded the authority and resources needed to implement, monitor and adjust the plan.

Perhaps the most significant omission was a clear statement on policy direction, said Shelley. “While priorities are mentioned, there is no categorical and explicate direction in the plan. There should be a clear mandate for the provision of life-saving harm reduction services, including needle and syringe provision and opioid agonist therapies.

“There should also be a clear statement on the Constitutional Court ruling that the use of cannabis should not result in arrest, and that the police performance indicators that call for the arrest of people who use drugs must be revised and arrest targets scrapped.

“Overall, the National Drug Master Plan 2019-2025 represents a significant change in direction when compared to previous plans. The shift in focus from the unrealistic goal of a drug-free South Africa is overdue.

“The new focus to reduce the levels of dependence and harm that the use of certain drugs can cause is pragmatic and allows a broader range of evidence-based and rights affirming responses. Another breakthrough is the recognition of the harms caused by the criminal justice response.”

SANPUD said it was worth noting that 48% of all convictions achieved by the National Prosecuting Authority are for drug-related offences, the vast majority of which are for the possession of small quantities of drugs. If the people who are incarcerated for these offences were to released, SA would immediately resolve the overcrowding of correctional facilities.

“The emphasis on poverty and how marginalised communities are disproportionally affected by current policies is a welcome shift in the understanding of what is needed to reduce the harms associated with drugs. Similarly, the emphasis on human rights is also long overdue. Current policies have infringed on the rights of some of the poorest and most marginalised communities in South Africa.

“For us Section Five: Strategic Intent describes the five principles that inform the plan, and these are excellent and progressive. Section Six: Outcome and target Populations is also very encouraging and aligns with earlier descriptions of how poverty drives the dependent use of drugs. The focus on key populations is promising.” said Shelly.

 

The updated national drug master plan was launched – aligning the 2013-2017 iteration with an ever-evolving understanding of addiction and shifting international policy trends.

Laying the foundation for “an effective response” to burgeoning substance abuse, among other things the new master plan seeks to prevent social marginalisation; promote “non-stigmatising attitudes” towards users and abusers; encourage them to seek treatment and care; and build the capacity of affected communities to address the issues concerned by way of prevention, treatment, recovery and reintegration.

This is noting the role of “effective law enforcement” in providing appropriate levels of “support” for what is essentially a community-based approach to addressing the problem. Given that poverty, inequality, and unemployment “remain key contributing elements to the increased use of drugs and the development of substance use disorders”, the plan also emphasises the importance of stimulating “robust and sustainable economic growth”.

 

SA National Drug Master Plan in full

 

 


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