Harm Reduction and the Death Penalty

By Tessie Castillo 11/04/15

Tessie Castillo reports from the 24th International Harm Reduction Conference in Kuala Lumpur.

The International Harm Reduction Conference

As my plane touched ground in Yogyakarta, Indonesia, a svelte voice came over the intercom. “Ladies and gentlemen. We hope you have enjoyed your flight with Air Asia. Just a reminder that drug trafficking is illegal in Indonesia and the penalty is death. Thank you and have a pleasant stay in Yogyakarta.”

Once I’d recovered from the shock of such a bold announcement coming over the intercom, I couldn’t help but crack a smile. I can’t get away from drug policy no matter how hard I try, I thought.

It was early October, the second of four weeks I’d spend island-hopping through Southeast Asia towards my final destination, Kuala Lumpur, Malaysia. In Kuala Lumpur, I’d attend the 24th International Harm Reduction Conference 2015, my first such event in five years working in harm reduction and drug policy in the United States. The weeks of travel prior to the conference were supposed to be a much-needed vacation from the rigors of advocacy for drug policy. But as I quickly learned, the specter of drug prohibition would follow me everywhere. 

In Bali, Indonesia, despite the death penalty for drug trafficking, I could hardly squeeze into a taxi at Kuta Beach before the driver would turn around and whisper, “Miss, would you like some hashish?” When I shook my head, I’d promptly be offered cocaine, ecstasy, or an array of other drugs until the disappointed driver was convinced that I really didn’t want any. 

At the youth hostels where I stayed, the other boarders would regale me with stories of foreigners who had been executed by the governments of many Southeast Asian countries for drug trafficking, as recently as a few months prior. And still there were drugs everywhere. 

Once in Kuala Lumpur, I attended a conference panel on the very topic of the death penalty for drug trafficking, which is still present in three of the countries I had just visited: Indonesia, Singapore and Malaysia, as well as several others, including China, Iran, Saudi Arabia, and, I noted ruefully, the United States (though unlike the other countries mentioned, the U.S. law is mostly symbolic).

Overall, 33 countries still have the death penalty on their books and about seven still hold regular executions, which total hundreds of people per year. (The exact number of executions is unknown since most of these countries carry them out in secret.)

The executions have caused international friction between countries. Indonesia, for example, has executed 14 people in 2015 so far. Only two were Indonesians; the 12 others were from Brazil, Nigeria, Australia, Vietnam, and the Netherlands. Brazil and the Netherlands actually withdrew their ambassadors from Indonesia earlier this year in protest of the executions, which occurred despite all efforts by governments and families to stop them. 

During the death penalty panel, Indonesian human rights lawyer, Ricky Gunawan, who represents death penalty cases, choked up as he recounted his last visit with Brazilian national Rodrigo Gularte just two days before his execution. 

“Rodrigo suffered from schizophrenia and he didn’t understand that he was about to be executed,” Ricky said. “He liked to talk about cats. He never had proper health treatment or diagnosis.”

Academic studies overwhelmingly report that the death penalty is not a sufficient deterrent to drug trafficking or use. In fact, one of the only countries to see a meaningful decrease in drug use in recent years is Portugal, which decriminalized the use and possession of all drugs in 2001.

via Hyun Namkoong

“People predicted that Portugal would become a drug user paradise after decriminalization,” says Rui Coimbra Morais, who spoke on the topic during another panel. “Instead, we have seen heroin use go down, along with overdose rates and HIV.”

The death penalty panel illuminated the most resounding theme that ran throughout the conference: the punitive drug policies of the last few decades have been largely ineffective at stopping drug trafficking or curbing addiction rates and have contributed to widespread health disparities, discrimination, and inhumane treatment of people who use drugs. Unfortunately, despite the fact that evidence of the derogatory effects of purely punitive drug policies is overwhelmingly clear, it’s still hard to convince public officials to change policy.  

“We can’t win,” Ricky Gunawan later lamented in an interview with me. “If drug use decreased in countries that have very punitive policies, which it doesn’t, people would say that the policies were working. But when we see drug use increasing in those places they say, ‘Well think how bad it would be if we didn’t have these harsh laws!’ It’s all political. Current policies are not effective at stopping drug use, only at sending the message that people who use drugs are not worthy of rights, dignity, or even life.”

Human rights violations towards drug users was a prominent topic of discussion and one that led to several speakers ending their presentations in tears. A speaker from India showed photos of people chained to benches in drug treatment centers, cuts and bruises raked across their bodies from beatings they received for trying to run away. In many countries drug treatment is coerced. Counselors use physical force or humiliation to make clients submit, and people in rehab are not allowed any contact with their families. 

Most disturbingly, I learned that these harsh penalties had not developed independently in each country, but had largely been instituted since the 1980s after the US launched its own War on Drugs. Our policies have influenced the countries where we invest, and although we may not beat people for leaving treatment or execute them for drug trafficking, this is how some other countries interpret the message coming loud and clear from the U.S.: people who use drugs are not entitled to the same rights and protections as everyone else.

But other than a few panels on the death penalty and torture, I was surprised at how similar the discussions at the International Harm Reduction Conference were to those held at harm reduction conferences in the United States. Sometimes only the accent of the speaker reminded me that I was half a world away from home listening to people from South America, Africa, Europe, Asia and Australia give the same testimonies that I hear from drug policy advocates in my home state of North Carolina. Even at the international level the same dichotomy exists between places where harm reduction programs such as syringe exchange and opiate substitution therapy are a routine part of public health policy (most of Europe and northern/western United States) and everywhere else, where harm reduction is not accepted by most people, the concept of government funding is laughable, and advocates have to fight tooth and nail for small victories that help save lives. 

via Hyun Namkoong

Another division I noticed, which I’ve also seen in the United States, is between people who use drugs and professionals who work in drug policy. In one especially striking panel, a health minister from Malaysia played a video portraying the stereotypical drug user: an unfortunate diseased person who couldn’t help but lie, steal and live like an animal because he was so consumed by drugs. Immediately following the video, a dignified speaker from Australia, who introduced herself as an active drug user, gave a tactful presentation on how the stereotypical portrayal of drug users as destitute victims contributes to the societal view that people who use drugs are less than human, thereby justifying punitive measures. The awkwardness in the room was palpable.

As with other harm reduction conferences, this one was rife with tensions, misunderstandings, and high emotions, but also with a sense of shared purpose and hope. Such a mixture of hope and tension occurred especially when Rick Lines, executive director of Harm Reduction International, held up a briefing paper drafted by the UNODC (United Nations Office of Drugs and Crime), which states that “treating drug use for non-medical purposes and possession for personal consumption as criminal offences has contributed to public health problems and induced negative consequences for safety, security and human rights.” The document encourages Member States to consider decriminalizing drug use and possession for personal consumption. 

This was great news for conference attendees, who waved copies of the paper in the air as photographers snapped pictures. The bad news was that shortly before the conference, the UNODC released a statement claiming that the paper had been prematurely leaked and refused to endorse anything it said. It was hard to tell whether the hands waving papers were trembling from excitement or anger.

Whether or not the United Nations decides to stand behind its paper, it’s about to get a whole lot of pressure from harm reduction advocates who are insisting that decriminalization of drugs and treatment of addiction through a health-centered model, not a criminal one, are necessary to end the often cruel and inhumane treatment of people who use drugs. And their next opportunity is coming fast. The UN General Assembly has called for a Special Session on Drugs in New York in 2016. The last such session in 1998 bore the now laughable slogan, “A Drug Free World – We Can Do It!” Harm reduction advocates are hopeful that the past decades of failed policy, disease and death with no decrease in drug manufacturing or use will find the United Nations singing a very different tune.

“Harm reduction is a strong movement,” says Annette Verster of the World Health Organization, who spoke at the conference. “There are not many other areas where a criminalized population has managed to get so many people involved from a range of different fields—law enforcement, public health, scientists, policy makers, activists, medical professionals, etc. The voice of drug users is loud and people are starting to listen.”

People are listening. They are acting. And they are locked, loaded, and ready for New York. 

Please read our comment policy. - The Fix
tessie castillo.jpg

Tessie Castillo is a writer and drug policy advocate in Raleigh, North Carolina. Her articles explore topics such as criminal justice reform, drug policy, and harm reduction. Castillo previously served as the Advocacy and Communications Coordinator for the North Carolina Harm Reduction Coalition (NCHRC), a statewide nonprofit that advances drug policy and criminal justice reform. During that time, she played a pivotal role in helping to legalize syringe exchange programs and expand access to naloxone, a medicine that reverses opioid overdose. Find Tessie at her website or on Facebook, TwitterInstagram, and LinkedIn.