Take drugs seriously!

To speak about drug use in society, especially if not done from an addiction or criminal perspective, remains somewhat of a taboo in Malta. It seems there is a hidden universal rule that when speaking about drugs, one must always repeat the decades-old mantra that drugs are bad, people should invest their energies in seeking ‘natural highs’, and that countries’ commitment to Just Say No [to drugs] campaigns will magically reduce the prevalence of drug use and risks associated with drug use in society.

Nonetheless, various experts in the field of drug policy and public health recognise that the War on Drugs has caused significantly more harm than the actual drugs it tried to curtail. It has contributed to several ‘unintended negative consequences’, amongst which increased health, social and legal risks for people who use drugs, and the emergence of new psychoactive substances and dangerous synthetic substances. This reality has for the past sixty years pushed whole generations into an information and public health limbo.

The United Nations World Drug Report published earlier this year estimates that, over the past ten years, global levels of drug use increased by 20%. The report also noted the emergence of new psychoactive substances and synthetic substances as a worrying development. These sentiments echo the New Drug Trends report published earlier this year by Correlation European Harm Reduction Network (C-EHRN). Through several peer-led focus group discussions held across cities in the EU, data from C-EHRN provided additional understanding of a diverse drugs market scenario, with new synthetic substances identified in various countries, including Malta. New substances such as synthetic cannabinoids and cathinones are posing unprecedented individual and public health risks. Both the UN Drug Report and that by C-EHRN sounded the alarm bells on the emergence of nitazenes, a group of synthetic opioids more potent than fentanyl that have increasingly been found in the global drug supply. Nitazenes are having a devastating impact on communities who remain unaware this deadly synthetic opioid is being mixed with their drugs.

In February 2024, the UN Commissioner for Human Rights Volker Türk argued that

policies regarding drugs need, above all, to advance human rights, including the right to health, [whilst continue to] shift away from punitive approaches, by decriminalising drug use and possession, setting up alternatives to incarceration, and broadening harm reduction services.

The fixation on preventing drug use, instead of recognising that prevention from harm is more effective in advancing public health aims, continues to negatively impinge on the right to health for people who use drugs, and is directly fomenting a culture of stigma and discrimination. Arguments in favour of preventing and/or delaying drug use, and of promoting natural highs such as engaging in outdoor activities and sports remain valid. Nonetheless, they become less impactful when trying to help people to make informed decisions on their drug use, be it for a legal substance such as alcohol and nicotine, or an illegal substance such as cocaine. For such decisions to be informed, education and evidence-based information, rather than scaremongering, is what is necessary.

Drug checking [pill/powder testing] as a public health tool.

The Trans-European Drug Information project, better known as the TediNetwork, is an important example of a broad understanding and implementation of the core principles of harm reduction. Without promoting or facilitating drug use, the network aims to act as a monitoring and information system focused on information sharing to optimize public health, prevention, and harm reduction interventions across the EU. The TediNetwork spans across 13 countries and is primarily composed of peer-led NGOs and professionals acting in the fields of health promotion and nightlife. It serves as an Early Warning System for people who use drugs and as a tool to monitor the evolution of drug markets in Europe. Unfortunately, no drug checking services are available in Malta, and people who use drugs have limited access to risk-preventing tools such as this.

To clarify, Drug Checking services do not analyse human samples for the presence of drugs to use as evidence for prosecutions of people who use drugs. By analysing drugs to detect their contents and returning the results of each analysis to service users, Drug Checking services adopt a proactive public health and harm reduction approach, making evidence directly accessible to members of the public. Embedded within a harm reduction consultation, information exchanged between the service user and the drug checking service is specific to that service user, who receives tailored advice. As attested by the TediNetwork, this approach instils trust and ensures services can fulfil a public health and not a criminal justice function, which is pivotal for the tool’s aim: to benefit the public and guarantee the right to health for people who use drugs.

The introduction of free and anonymous Drug Checking services and better community access to the Early Warning System should be urgently discussed in Malta. The availability of accessible, real-time, peer-led drug checking services and non-judgmental consultation by trained professionals is key to preventing unnecessary risks caused by drugs, including the accidental ingestion of potent, synthetic substances. In the end, and as attested by the UN Human Rights Commissioner, proactive and human centred drug policies are the key ingredients to positively impact behaviour, and ultimately, save lives.

Karen Mamo – MSc Addiction Studies, MSc Conflict Resolution and Mediterranean Security

Dr Giulia F Zampini – Associate Professor of Criminology and Social Policy, University of Greenwich, UK