There are programs in the United States, Canada, and Brazil that provide crack users with inhaler pipes (to decrease the transmission of respiratory diseases), together with condoms and flyers that talk about the risks of crack use and risky sexual behaviors.17 Studies have shown that the distribution of these kits increases availability and use of safe inhaler materials and reduces the frequency of some risky practices, although the impact that this measure has on the transmission of infectious diseases is not yet known.
Some countries have needle exchange programs for intravenous drug users, to reduce the transmission of HIV and hepatitis C. In most countries with such programs, needle exchanges are part of programs that include other prevention methods, such as mobile needle distribution units and distribution of materials for needle sterilization. Only Canada has a program for supervised administration of injecting drugs. Only Canada and the United States distribute opiate agonists—maintenance drugs such as methadone—as part of their preventive measures to reduce the transmission of infectious diseases.
5.5 Decriminalization of drug use needs to be considered as a core element in any public health strategy. An addict is a chronically sick person who should not be punished for his or her dependence, but rather treated appropriately. If it proves impossible to adopt such a radical shift in treatment from one day to another, a start should at least be made with transitional methods, such as drug courts, substantial reductions in penalties, and rehabilitation. Incarceration runs counter to this approach and should only be used when an addict’s life is in danger or when his or her behavior constitutes a threat to society.
- Alternatives to punishment
In May 2013, the Organization of American States released two groundbreaking reports – an analytical and a scenarios report, promoting a balanced approach toward drug control, including the provision of harm reduction, the decriminalisation of people who use drugs, and the need to experiment with innovative drug policies, including regulatory regimes.