DRUG USE AND THE QUESTION OF AGENCY

According to the United Nations Office on Drugs and Crime, 275 million people used narcotics in 2021, representing a 22% increase since 2010. Drug users may be uniquely complex rights bearers, and their circumstances raise questions about the significance of agency in assessments of both social precarity and human worth. Drug users may be physically dependent on narcotics, divorced from their capacity to choose. Dependence may begin after receiving a prescription for pain medication; it may begin in adolescence, before the brain has fully developed. Scientists have found strong indications that trauma and stress are correlated to drug use, and that some people are hereditarily predisposed to addiction. These conditions, among others, may dilute a drug user’s agency, without eliminating it entirely.

The public response to drug use often oscillates between punitive dismissal and heavy handed, paternalistic intervention. In my view, the former correlates with a perception of drug users as responsible agents, and the latter with a perception of drug users as helpless subjects of their dependence. Despite their oversimplicity, these attitudes tend to inform policy paradigms around the world.

RECENT EXAMPLES OF INTERNATIONAL DRUG POLICIES

The United States continues to struggle with the legacy of the racially charged war on drugs and its disciplinary response to the crack epidemic. The subsequent decades-long surge in opiate use is thought to give way to a burgeoning synthetic drug emergency. Novel forms of meth production have been linked to long term psychosis and increased incidence of homelessness in western American cities. Fentanyl related deaths are spiking simultaneously. A great deal of US drug policy is piecemeal, adopted and carried out on a state-to-state basis. As a result, and in the wake of decades of overly punitive criminal justice campaigns, the US response to the accelerating narcotics crisis has been somewhat paralytic.

Despite the well-publicised failures of the US’s approach, the UK government appears to also be doubling down on its efforts to install a punitive policy paradigm, unveiling a 10 year drug strategy in December of 2021. The plan emphasises enhanced police presence, border security, and carceral surveillance. The UK’s decades-long embrace of criminalisation has dovetailed with a considerable hike in documented instances of drug use. While this does not necessarily imply a causal relationship, it does suggest that increased criminalisation is perhaps less effective than historical models, wherein drug use was largely delinked from criminal justice prosecution.

Further, while the situation in the US cannot be neatly mapped onto the UK, certain through lines remain consistent and should make policymakers wary. As a rule, the US tends to reject social safety nets, instead emphasising a narrative of individual responsibility, which depends, ultimately, on the presumption of individual agency. In this way, the US has entrenched an account of increasing drug use that continues to neglect the contexts—poverty, inadequate mental health treatment, predatory pharmaceutical sales—which precipitate drug use, or else make it so deadly.

To invoke another topical example, the Taliban, which now presides over the country that supplies more than 80% of the global opiate supply, has recently cracked down on drug users, rounding them up in the streets, placing them in treatment, and confining them until their detox is complete. It is unclear yet how effective this system might be in encouraging users’ temperance and it is another question entirely whether drug policy should be primarily devoted to enforcing abstinence. What the situation in Afghanistan does illustrate is a paternalistic approach, wherein the perception of the drug user hews more closely to the archetypical helpless subject, whose agency is subordinated to the priorities of the state.

In a more localised but no less topical context, Paris’ government is currently foundering in the face of considerable crack use in the city’s northern neighbourhoods. In response, the mayor has introduced a number of contradictory policy measures. The city has forcibly removed crack users from within the city’s periphery and built a wall between their encampments and nearby gentrifying neighbourhoods, but is also, in stark contrast with these vindictive measures, opening several centres for safe drug use. Safe use efforts are generally based on harm reduction principles, which evaluate the needs of the users as well as the community and seek solutions that do not set these groups in opposition to one another.

DRUG USE, DIGNITY, AND HARM REDUCTION

As global drug use continues to increase, the human rights community can participate in reforming the public perception of drug users by way of its discourse. One of the most prevalent obstacles faced by drug users is the deeply entrenched social stigma associated with drug use.  According to several human rights experts, including the seminal scholar Jack Donnelly, human rights at their most essential are about the recognition of human dignity, which Donnelly defines broadly as a human being’s “special moral worth”. Human dignity is often the very thing that is at stake when drug users are perceived as either culpable for their narcotic dependence, or else stripped of their capacity to make meaningful choices for themselves. Human rights discourse circumnavigates the pitfalls of agency evaluations, instead affirming absolutely that drug users are endowed with a special moral worth, which can, in time, provide an improved basis upon which to make policy decisions.

While the situation in Paris remains fraught with difficulties, the inclusion of harm reduction programs is promising. The National Harm Reduction Coalition in the United States openly relies upon human rights discourse, affirming that “harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs”. Recent studies on harm reduction techniques, such as needle and syringe programs, have demonstrated their efficacy in reducing HIV. Portugal, another imperfect but nonetheless encouraging example, has made steps to decriminalise drug-related offences and has subsequently seen a marked increase in participation in treatment programs and significant decrease in drug-related fatalities. In all, the inclusion of these programs hints at a future in which agency calculus is de-emphasised in favour of other, more compassionate policies which recognise human dignity.

Kendra Mills (she/her) is a program officer at the Center for Critical Democracy Studies and a volunteer researcher with the Education Justice Project. She holds an MSc. in Human Rights from the London School of Economics and is interested in alternative justice projects, technologies, and solidarity. Her writing can also be found on the LSE Human Rights Blog, the LSE Social Policy Blog, and in the Yale Historical Review.

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