»Das Drogenproblem auf dem amerikanischen Kontinent«

Introduction:

The past two years have seen a much more active and intense hemispheric discussion of drug policies. There appears to be greater openness now to a dialogue on current policies and, in some sectors, a willingness to explore nontraditional approaches to the subject. 

The intensity of the violence associated with drug trafficking - especially in countries affected by the production, transit, and trafficking of illegal drugs - has been the principal factor in driving the concern of senior level officials in becoming more actively engaged in this debate. Other factors include shifts in drug consumption patterns in the Hemisphere, increased prevalence of drug use, violence affecting the most vulnerable segments of society, and growing demand for health care services to treat addictions. 

Reflecting their concerns over the impact of drugrelated violence and the continuous flow of drugs in the region, hemispheric leaders, former Heads of State, academics, and representatives of civil society have supported the adoption of policies geared to downplaying the role of the criminal justice system in drug control. Reports by highlevel groups, such as the Global Commission on Drug Policy, emphasize the need to reduce the harms done to the health, security, and well-being of individuals and society, and favor an approach in which drug use is treated as a public health issue and consumption reduced through evidence-based prevention campaigns. Among other recommendations, they also encourage experimenting with legal regulation models for certain drugs. 

At the same time, other voices suggest it is premature to assume that current approaches to the subject have failed. While acknowledging shortcomings in the implementation of current approaches, they maintain that, at the domestic level, countries are only now beginning to execute policies that are consistent with the “Hemispheric Drug Strategy” and its “Plan of Action 2011-2015,” adopted in 2011 by the member states of the Inter-American Drug Abuse Control Commis - sion (CICAD) of the Organization of American States. This Strategy calls for an integrated and balanced approach to the formulation of drug policies: one that emphasizes supply and demand reduction, paying particular heed to control mea - sures and international cooperation in line with United Nations Conventions on the subject. 

There are points of consensus between the two approaches: both recognize that dependence on drugs is a chronic (or recurrent) illness that requires a public health response (treatment) and both agree on the need to promote evidence-based drug control policies and to incorporate gender issues and civil society participation in policy formulation. Both approaches focus on the human dimension of the problem by refraining from characterizing drug users merely as objects of the criminal justice system, and by promoting alternatives to imprisonment for drug- dependent individuals who have committed crimes. 

As the discussion progresses, it is becoming clearer that, despite international interest in the subject and all the resources allocated to its analysis, little is actually known about what works or how to deploy best practices that are not just well known but are also available for implementation and replication. 

There are numerous good examples of this: initiatives that enrich dialogue and can inspire each country to understand how it can successfully manage the various challenges posed by drugs within its particular context and economic, political, and social circumstances. Examples worth citing include: the recovery of a State presence in rural areas and drug corridors in Colombia; community-oriented policing models in Nicaragua and Brazil; the Peruvian Alternative Development Model in San Martin; the decriminalization of possession for personal use in many countries (which, while reducing the burden on consumers and the judicial system, has not resulted in increased use); innovations in criminal jurisdiction and overdose prevention in the United States; needle exchange and other harm reduction programs aimed at preventing unsafe needle use and HIV transmission in Canada; social oversight to contain coca growing in Bolivia; the development by the United Nations Office on Drugs and Crime of International Standards on Drug Use Prevention; and the forging of strong health promotion institutions in Chile and Costa Rica. 

In addition, we have gained much better insight into many of the factors surrounding initial and ongoing drug use, along with increased scientific knowledge of the risk factors that help to explain why a minority of users develop problematic habits. We also now have a better understanding of the social setting and norms that contrubute to addiction and may harm both individuals and society as a whole. 

We also now know that usage patterns are evolving. For instance, cocaine use is increasing in Southern Cone countries and declining in the United States, whereas marijuana use is on the rise and the unlawful use of pharmaceutical drugs has become the principal concern. With respect to the United States, it is worth noting that, although marijuana use is still illegal in most states, changes in public opinion were reflected in the 2012 vote to legalize that substance in two states and most citizens agree that marijuana should be legalized and regulated. This is not reflected in the public opinion of most other countries in the Hemisphere. 

Growing media attention regarding this phenomenon in many countries, including social media, reflects a world in which there is far greater awareness of the violence and suffering associated with the drug problem. We also enjoy a much better grasp of the human and social costs not only of drug use but also of the production and transit of controlled substances. The world is also conscious of the vast illicit economic structures forged by profits from the illegal drug trade: a business with profits that distort economies, enrich and empower organized crime, and foster public sector corruption. 

Part of that concern also relates to the economic and social costs associated with drug control laws and policies currently in place. Investments designed to expand police, judicial, and prison capacities in this regard may detract from investments in health, education, and other social goods. 

The above concerns are reinforced by the finding that the impacts of the drug problem on individual countries are varied, such that reactions to that problem also vary, as do the effects of those reactions. Domestically, some countries are facing relatively high rates of illicit drug use and its related consequences in terms of public health and criminal behavior. Other countries are not among the leading users of controlled substances, but are exposed to higher levels of violence, trig - gered in part by actions by the security forces to counter illegal drug production, trafficking, and transit and the criminal violence associated with them. While some countries are financially and institutionally better equipped to address the harms caused by drug use and the illegal market and to defray the costs of drug control, other countries find it more difficult to cope with these problems. That is why policies that might be useful for some countries (such as cutting funds for transit control) may be regarded by other countries as highly dangerous, thereby render - ing international cooperation very difficult. Undoubtedly, therefore, future discus - sions of drug policy will yield not only agreements, but also major disagreements. 

Nevertheless, major advances have been achieved. There is a much better understanding of drug dependence, which is now treated as a public health problem. Cocaine use has declined in what were once significant markets. Huge drug-trafficking organizations have been dismantled, and their leaders tried and convicted. Countries have set up financial intelligence task forces to fight money laundering. International cooperation mechanisms have improved. Over half the countries in the Hemisphere have put into place national drug control strategies. Primary and secondary school prevention programs are on the rise. Countries have enhanced their ability to conduct periodic national drug use prevalence surveys. Finally, the rule of law and judicial reforms have been strengthened in several countries. 

The other side of the coin is that funding for drug control programs remains weak, especially with respect to prevention and treatment. Although drug seizures have increased, the overall flow of drugs remains stable and robust. Alternative development programs have achieved some local-level successes, which have not, however, been replicated nationwide. 

Conscious of all these facts on the ground and the challenges they pose, the Heads of State and Government of the Americas decided to forge ahead in the quest for more effective ways to unravel and handle this complex problem. To that end, an explicit mandate was assigned to the Organization of American States. 

„We, the region’s leaders, held an invaluable discussion on the global drug problem. We agreed on the need to analyze the results of the current policy in the Americas and to explore new approaches to strengthen this struggle and to become more effective. We have issued the OAS a mandate to that end.“

(Closing Statement of the President of the Republic of Colombia, Juan Manuel Santos Calderón, Sixth Summit of the Americas, Cartagena de Indias, Colombia, April 15, 2012.) 

The purpose of this Report on the Drug Problem in the Americas is to reflect that agreement and fulfill that mandate. Our intention is to help the Heads of State and Government of the Americas establish a frame of reference to address this problem in their countries and to guide future multilateral policies and actions. 

In order to fulfill that task as broadly and usefully as possible, we decided to adopt two different and yet complementary approaches. This involved, on the one hand, carrying out a technical study of drug use, production, transit, and trafficking and of the scope of the drug business in the Hemisphere, while at the same time examining the public policies adopted to address the problems of public health, illegality, and violence that they give rise to, as well as their social and political impact on our societies. We refer to that part of the report as the Analytical Report. As an important complement to this effort, we determined that it was important to develop scenarios for the Drug Problem in the Americas Report, which, unlike the Analytical Report, would not examine the current state of af - fairs, but rather possible future drug trends. This report was developed based on opinions and perspectives of leading academics, political leaders, social leaders, and experts from all over the Americas, representing all schools of thought on the subject, who eagearly took part in this endeavor. 

The Analytical Report presented in this volume synthesizes the studies – which are also published as annexes - carried out by high-level professionals dur - ing the second half of 2012. It is divided into 10 Chapters, starting with a definition of the problem and an explanation of how it will be examined. The analysis itself begins in Chapter 2 with a look at the reasons that led society to concern itself with the use of certain substances and to decide to control them, in other words the effects of drugs on human health. Recognizing that this necessary choice triggered the illicit economic activity designed to satisfy the demand for banned substances, we devote Chapters 3, 4, 5, and 6 to a detailed study of how, in our region, controlled substances are cultivated, produced, distributed and sold. In undertaking that study, we examined the volume of activity, its various manifestations, its environmental impact, and the State’s response to it, including the consequences and limitations of that response. 

Chapter 7 is dedicated to the examination of different drug consumption patterns in our countries, with a special focus on the reasons that lead people to use drugs, on possible and currently practiced forms of treatment and preven - tion, on the effects on social exclusion and the exercise of human rights, and on the ways in which our States have reacted, along with their consequences and shortcomings. Chapter 8 provides a detailed account of the different manifesta - tions of criminal violence associated with the phases of the value chain in the illicit drug economy, including the violence found in the consumption phase. We focus, in particular, on possible reasons why that violence is more intense and virulent in some countries than in others, with inevitable comparisons between death rates from drug use and from other criminal activities. Chapter 9 examines legal and regulatory alternatives for addressing the problem; their origins and characteristics; current trends toward decriminalization, penalty reduction, and legalization; the likely costs and benefits of those various alternatives; and other, non-juridical, options. 

Finally, in Chapter 10, we offer our own contribution to the dialogue commencing with the presentation of this Report , setting forth the criteria that lead us to approach the Drug Problem in the Americas as a hemispheric issue that can be viewed as a single process which allows for different approaches to each of its phases and for each of the countries in which those phases take place. We conclude, too, that there is no absolute link between the drug problem and the insecurity experienced by many citizens in the Americas. While that relationship varies for each country or group of countries, it is clear that insecurity is more prevalent in societies in which the State is not in a position to deliver effective solutions. We also stress that a public health approach is needed to address drug use. Finally, we further conclude that the drug problem needs to be dealt with in a flexible, differentiated fashion, wherein countries adopt an approach tailored to the particular ways in which they are affected. 

To do justice to the complexity of the Drug Problem, we needed to reach out to consult numerous differing points of view, and to allow ideas to flow freely in an open-minded setting. That was the justification for undertaking the second The Drug Problem in the Americas | Organization of American States 9 part of our report, entitled Scenarios for the Drug Problem in the Americas . To put together the Scenarios Report, we brought our partners in Reos Partners and Centro de Liderazgo y Gestión together with a large number of specialists and individuals deeply involved with the drug issue–intellectuals, government authorities, public health specialists, and social and community leaders–who were brought together in structured workshops to imagine how the Problem might evolve in the future. Since we also recognized that there is not just one future, but numerous possible futures that could be forged on the basis of the decisions we make today, we put forward four possible versions of what the “Drug Problem in the Americas” might look like in the future. None of them represents what will in fact happen or what we would like the future to look like, but all of them could come about if certain events occur and certain political decisions are taken. Familiarizing ourselves with these possibilities, analyzing their causes and effects, and drawing conclusions from them are tasks that we consider to be not just useful but essential for our individual and collective thinking about the Problem. 

Three of the four scenarios – “Together” , “Pathways” and “Resilience” - describe different future alternatives, depending on whether the focus is largely on institution building, experimentation with legal changes, or the community’s capacity to respond to the problem. The fourth, “Disruption,” alerts us to what could happen if we are incapable in the short run of reaching a shared vision that allows us to join forces to address the problem, while respecting diversity in our approaches to it. 

Each of these scenarios poses an enormous variety of collective and mul - tilateral opportunities and challenges that should lie at the heart of subsequent debate. With drugs, as with any other complex social phenomenon, there is a wide range of motivations and convictions that shape the social fabric. Conse - quently, these scenarios provide a useful starting point for helping our leaders and, ultimately, our peoples establish collective and sustainable roadmaps within the diversity of approaches. 

Both the Analytical Report and the Scenarios Report, which together constitute this Report on the Drug Problem in the Americas are the fruit of a collective effort by a large number of specialists, social leaders, academics, politicians, business leaders and civil servants from all the member states of the Organization of American States, and of the invaluable support provided by the staff of the General Secretariat of our Organization. I wish to commend and thank all of them for the devotion and skills they have demonstrated in bringing this collec - tive endeavor to fruition. 

In this way, we have responded to the explicit mandate conferred upon us by the Sixth Summit of the Americas. In bestowing on us the privilege of compiling this Report, the Heads of State of the Americas entrusted us with an enormous responsibility while, at the same time, setting very precise limits on the scope of our response. For that reason, in this Report, we lay out facts that can sup - port decision-making, but we do not impose solutions. It is up to our leaders to develop those solutions, knowing that, in the debates to come, they can rely on a firm basis for their deliberations. This Report, does not, therefore, provide a conclusion, but rather the start of a long-awaited discussion . 

José Miguel Insulza Secretary General of the Organization of American States

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