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The intersection between drug control and the death penalty represents a key nexus for human rights and drug reform advocacy and constitutes one of the most visible examples of the link between abusive law enforcement and drug control in the current period. The issue has emerged as a flashpoint of international debates on drugs and is one that raises important questions and challenges for both ‘abolitionist’ countries that oppose the death penalty and ‘retentionist’ States that continue to execute people. The death penalty for drug offences cannot be dismissed as simply an internal matter for States. Not only do executions for drug offences violate significant international human rights legal protections, domestic capital punishment laws in many cases cannot be separated from the influence of the international drug control treaty regime. This chapter will explore the question of the death penalty for drug offences and the challenges it presents for the international drug control regime more broadly.¹

This chapter analyses major issues surrounding the Annual Report Questionnaire (ARQ) – the key mechanism through which the UN collects data on various facets of the world’s illicit drug market. As the ARQ is currently under review by the United Nations Office on Drugs and Crime (UNODC), the authors suggest ways to incorporate the gains made at the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem.

The UNGASS Outcome Document has, to certain degree, enabled the international community to move away from the simplistic goals of a drug-free world enshrined in the 2009 Political Declaration and towards a more comprehensive health- and human rights-based approach. The UNGASS has also laid important groundwork for the 2019 Ministerial Segment, where member states will delineate the global drug control approach for the next decade. In this context, the issue of metrics and indicators has a critical political role to play as it will shape how member states will measure progress against their international drug control commitments.

Starting with a review of the ‘triple trouble’ – poor data quality, low response rates from Member States and other inconsistencies that have long persisted with the ARQ – the chapter moves on to offer substantive critiques on the content of the Questionnaire and ways to better incorporate issues related to health, human rights and development. The chapter concludes by providing guidance on possible synergies with the Outcome Document and the Sustainable Development Goals, bringing international drug control in line with the UN Charter.

Injecting drug use is a global concern, with an estimated 16 million people who inject drugs (PWIDs) in over 148 countries. A number of Asian countries detain PWIDs for compulsory treatment. The paper aims to discuss this issue.

The authors reviewed the literature on compulsory drug treatment in seven Asian countries.

The authors identified 1,269 closed settings which held over 600,000 drug users in eight countries. The average detainee was aged from 20 to 30 years and was predominantly male. HIV risk behaviour continued in detention in some countries. In most countries treatment comprised physical labour, military drills. Methadone maintenance treatment and antiretroviral therapy were rarely available. No data were located to show detention in a closed setting treated drug dependency. Issues of concern were; no due legal process for the detention of drug users, lack of evidence-based drug treatment, lack of HIV prevention and treatment, abusive conditions, forced labour and exercise, arbitrary exit procedures and very high relapse rates.

The review of compulsory treatment of drug users failed to find any evaluation of effective drug treatment for detainees. Instead serious breaches in human rights conditions were evident. Prominent international organisations have called for the compulsory treatment of drug users to cease.

Many countries are spending vast amounts of funding on ineffective treatments for drug users.

Funding should be directed to community-based drug treatments that have been shown to work.

This is the largest review of compulsory treatment of drug users to date.

Global drug policy has undergone significant change over the past decade, especially with the advent of the 2016 UN General Assembly Special Session (UNGASS) on drugs. This was a catalyst moment both in highlighting the need for a gender perspective in drug policy, and in initiating a review of the indicators used to evaluate progress in drug policy.

To date, the UN has not adequately tracked gender-specific data in drug policy. This is symptomatic of the lack of focus granted to the specific vulnerabilities and needs of women in the illicit drug trade. This has resulted in a knowledge and understanding gap in relation to the issues faced by women worldwide.

The importance of quantitative and qualitative data and analysis of how and why women are involved in the illicit drug trade, and how this relates to their age, ethnicity, socio-economic status, family situation and history of trauma, violence and mental illness cannot be understated. Without adequate indicators on the underlying factors of their engagement in the trade, the differentiated impacts that both drugs and drug policies have on their lives, and the vulnerabilities they may face, policy makers will be unable to design and implement drug policies that are truly effective.

This chapter provides a historic overview of how data on women has so far been tracked by the UN. The chapter will then look to the future, focussing on opportunities to identify more meaningful indicators within a revised Annual Reports Questionnaire, and also by leveraging the Sustainable Development Goals, UN human rights mechanisms and civil society research.

This chapter explores the relationship between the global drug policy agenda and the United Nations Sustainable Development Goals (SDGs). Development is one of the key pillars of the UN's charter; however, sustainable development and drug policy have existed in separate policy spaces for decades. During 2015 and 2016, two parallel processes took place at the UN – the adoption of the 2015 SDGs, superseding the Millennium Development Goals, and the 2016 UN Special Session on the world drug problem (UNGASS), a global convening of countries to create a way forward to address illicit drugs. This chapter explores how a group of reform-oriented countries, UN agencies and civil society stakeholders used the UNGASS to advocate for better policy alignment with development principles. While some headway was made, tensions remain about allowing a development approach into the drug policy realm. This chapter argues that given strong pushback to maintain a law enforcement-driven agenda by many countries, better alignment will not happen without more clarity on what sustainable development–driven drug policy is and without champions to push these ideas in the drug policy arena.

Parallel with trends in the wider East Africa region, there has been an increase in the number of women involved in drug use, trafficking and drug-related crime in Kenya (Beckerleg, Telfer, & Hundt, 2005 ). Vulnerable populations, such as domestic labourers, ethnic minorities, those living in slums, bar attendants, sex workers and refugees, are recruited into criminal organisations and assigned roles that expose them to negative health outcomes, human rights violations and incarceration (NACADA, 2016 ). In cases where women do not directly participate in drug use or the drug trade, they often are responsible for mitigating the risks arising from drug use by family members and the community. This reflects their triple burden of care and support when family and social life deteriorates (Mburu, Limmer, & Holland 2019).

The Kenya Narcotic Drugs and Psychotropic Substances Control Act of 1994, criminalises possession and trafficking of illicit drugs. The enforcement of this legislation has led to an increase in the number of women incarcerated in Kenya for drug, but also (and mainly) alcohol offences. This goes against the recommendation of the UN Commission on Narcotic Drugs in 2005 that States should adopt innovative measures and policies that prioritise treatment and rehabilitation as opposed to incarceration. In Kenya, prisons have adopted the Mandela and Bangkok Rules, enabling a paradigm shift in the provision of correctional services for women offenders, including remote parenting, family open days and linkages to aftercare services. However, these policies need to be anchored in the legal framework, with adequate resources to hasten the realisation of goals for the care and treatment of female drug and criminal offenders.

This chapter discusses the genealogy and development of the ‘access abyss in palliative care and pain relief’ affecting 80 per cent of the world’s people. It argues that the larger context is an epistemic abyss constituted by incomplete information about the need for controlled medicines for pain relief, and that decades of drug policy based on supply control have prevented development of the necessary knowledge base in many countries. Transnational civil society organisations are working to map and bridge this abyss through education, advocacy and action. Deeper (original) systemic and tensions in the original multilateral drug control narrative produced the current epistemic/clinical abysses and now provide space for more participatory civil society involvement. Where the earlier narrative focussed on a fear-based drive to discipline and punish non-medical use of controlled substances, the evolving (and still contested) ‘world drug problem’ narrative foregrounds person centred, human rights based, public health approaches to drug policy that explicitly support improved access to internationally controlled essential medicines. Recommended policies can only be operationalised through a concerted ‘all hands on deck’ effort guided by the international law principle of ‘mutual and shared responsibility’ for improving access within the context of the 2030 Agenda for Sustainable Development. This calls for enhanced communication, concerted advocacy, collaboration and pluralist praxis to fill the often gaping abyss between ‘black letter law’ — what is actually written in the drug control conventions — and how member states learn to interpret and operationalise it.