Video 2: The international scheduling of drugs

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Drugs, drug use, drug policy and health

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University of Geneva

Drugs, drug use, drug policy and health

1 оценка

This MOOC is the first of its kind, since it addresses critical issues related to drugs from a multidisciplinary, health and human rights-based approach. Throughout the course you will cover a range of questions including what are drugs and why they controlled? What are the benefits and harms of taking drugs? How public health policies can address drug use? You will also learn about the intricacies of the international drug control framework and the negative consequences of widespread prohibitionist drug policies around the world. Finally, you will examine ways of furthering drug policy reform. The topics will be presented by over 40 speakers from scientific, academic and institutional backgrounds, spokespersons of civil society as well as people who use drugs presenting their views. By the end of the course you will have: - a strong understanding of the major health issues related to drug use and drug policy; - a clear vision of why drug policy is debated today; - and, if you so wish, you will be equipped to engage in the drug policy reform movement at your local or regional level.

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MODULE 5: Medical access to opioids for the management of pain and to other controlled medicines

Welcome to Module 5 which looks at access to controlled medicines. During this week, you will learn how the international scheduling of drugs works; be presented with some of the main barriers to access to essential medicines and look specifically at the case of the opioid epidemic which is ravaging through the United States at the moment. The medical use of cannabis and cannabinoids is also a highlight of this week and one that is particularly relevant in a number of countries around the world at present. By the end of this Module you will be able to: • Describe the scheduling of controlled medicines; • Recognize the barriers to access to controlled medicines and discuss the challenges posed by prescription drugs epidemics; • and examine the current issues around the medical use of cannabis and cannabinoids. We hope you enjoy this week, which is slightly different to the other Modules in terms of its specific topic but adds a lot of important information in terms of understanding the international drug control framework and issues related to drugs, drug use and policies as well as possible. Best wishes,The Drugs, Drug Use, Drug Policy and Health team

Video 1: Introduction to Module 53:55

Video 2: The international scheduling of drugs9:31

Video 3: How the international system of scheduling of drugs works: the WHO perspective3:27

Познакомьтесь с преподавателями

Michel Kazatchkine
Senior Fellow
Global Health Center, Graduate Institute for International Affairs and Development, Geneva
Barbara Broers
Professor (in Addiction Medicine)
Community Health Departement, Geneva University Hospitals
Aymeric Reyre
Senior Lecturer
Faculty of Medicine, Paris 13 University
Jennifer Hasselgard-Rowe
Researcher and Lecturer
Institute of Global Health, University of Geneva

[MUSIC]

This video focuses on the international scheduling of drugs.

And we have the pleasure of speaking to Gilberto Gerra from the UN Office of Drugs

and Crime in Vienna.

Hello Gilberto. >> Hello.

>> Could you please start

by briefly introducing yourself.

I'm the chief of the head branch here at the UNODC,

United Nation Office of Drugs and Crime.

My branch is taking care of preferential treatment of dependents,

HIV AIDs among the user and in prison setting and sustain their livelihood.

All the humanitarian social and health issues that are not reinforced in

the organization are in my branch. >> Thank you and could you tell us how

drugs are currently scheduled? >> A certain number of drugs are under

control and scheduled in the convention starting with

the convention of 61, 1961, then 71 and 1998,

that have been almost unanimously adopted by member states.

Considering these drugs on one side essential, indispensible for

alleviating one's suffering particularly, for pain medication, on the other side,

dangerous and in the condition to induce addictive behavior, and a lot of dangerous

consequences that have been considered the need of keeping them under control.

The convention of 61 is particularly on narcotic drugs and some synthetic drugs.

The 71 is in specific on synthetic drugs and psychotropic drugs.

And the convention of 1988 is on both narcotic and psychotropic drugs.

Being in schedule one, the highest level of restriction of

control means that the drugs has to be imported, exported under control

of the state with the cooperation with the International Narcotic Control Board,

that has to be labelled, has to be prescribed, and so this is done to

avoid that there is a diversion of abuse of these drugs to the non-medical use.

We cannot say that these drugs are prohibited.

These drugs are not permitted for non-medical purposes but

they are absolutely essential and permitted for medical and

scientific purposes. >> And

could you explain how the scheduling is central to the international drug control

framework? >> Yes, the scheduling is,

when you start to have an international body that says the international board,

that is granting the license to import, export in cooperation with

the international authority, it means that this cannot be bought or

sold without any control and move it from a country to another without any control.

On the other side, you need that so

you really know what is sold, what is bought on the formulation and

then they need a prescription of a medical doctor.

So it means that a medical professional has to take

the responsibility of prescribing this medication.

Clearly, the unbelievable things that happen in many years in

most of the countries was sort of overruling in respect to the convention.

With the myriad of rules and regulation

that have created a sort of difficulty to access, to have availability and

access to this medication, that was not the purpose of the convention.

The convention wanted simply to control abuse and

diversion and misuse, but making these drugs absolutely available and

accessible for medical purposes. >> But do you think there's a legitimate

basis for prohibiting drugs? >> As I said,

I never use the word, prohibiting drugs.

Also, I think, in some text in the past, we were called when the joined,

and the INCD the prohibitionistic regime.

And there is nothing totalitarian and nothing prohibitionistic in our work.

It is a drug control system.

It means that these drugs are not legitimate for

no medical purpose, but this is absolutely not only related to the convention.

In my view, it should be related to the common sense.

Imagine to have a prescription of antibiotics for

not pneumonia, or for no fevers, or someone asking for

prescription of insulin for no diabetes.

When you go outside the necessary use of this drug for

medical reasons and you go in any case to provoke something that is not good,

imagine that insulin that is not under control can provoke a hyperglycemia coma.

The glucose is going to go down in the blood and killing the person.

Antibiotics are dangerous for the liver or can create an allergy and you should

not prescribe it when you don't have the absolute need for using antibiotics.

And moving to the control of drugs, that says heroin, cocaine, cannabis, and

amphetamines for example, the first four of the convention of 61 and 71,

I think that these, when they are used for

non-legitimate medical purposes, they can be absolutely very dangerous.

The first issue that they create, they create the dependence.

They are stimulating the reward system in the brain and

this kind of appreciation for the reward is creating, is generating

a sort of intensive, comparative behavior, conditional behavior.

And the extinction of this behavior is very difficult.

So this means that people who are engaged in substance use disorder and

are clearly in need of treatment for a long time,

because their brain has been significantly affected by these drugs

outside any medical reason. >> But as a physician,

how do you see drug use and drug dependence in relation to pathology?

I have to say, I'm very happy in this generation, because myself as

a neuropharmacologist, neurobiologist, and a doctor, I've had a great reward,

great satisfaction to see the general assembly last year that in New York,

unanimously, 193 countries out of 193, define the dependence a complex

multifactorial health disorder, with chronic in nature.

It means that the member states unanimously recognize that we

are not in front of a criminal behavior, we're not in front of a moral failure,

we're not in front of only a social consequences of something, but

we are in front of a health disorder, a complex multifactorial health disorder.

And it is clear which kind of policy we should adopt to respond to a disorder.

We should, for sure, stop any punitive and coercive approach, any coercive,

punitive, and sanction oriented approach, and adopting a social protection approach,

education, information, and public health approach, treatment, rehabilitation and

social reintegration. >> Thank you.

Do you have anything else that you'd like to add?

>> I can add that in my view,

I don't know if this is a personal opinion or could be shared around the convention,

the facts that have been depicted in the past as a repressive tool or

misinterpreted by someone as a repressive tool,

in reality are protecting the new generation from this no sense use

of drugs outside medical purpose but they're protecting a special population.

They're protecting the most vulnerable children and adolescents.

In most of the cases they're protecting the children of the poor.

the people who have had no opportunity, no advantages in life,

they are not privileged children.

They have to go to work at 7 or 11 years old,

and they are not in school, they are a victim of school dropout.

They have been abandoned by the institution.

Particularly, these people, children who are working, as I said, at 11,

or girls that were in the brothels in because

of prostitution as 13-years-old children, or child soldiers in Africa

that are given cocaine by their commander to fight better, or children used for

labor for and sort of slavery in the modern world.

And all these categories are also treated with drugs and

are familiar with drugs and not what is called recreational use.

The word, recreational use, is in my view,

very well used in high income countries with the rich, with the affluent while

doing their use of drugs in a recreational way and they stop when they want.

But many other part of humanity, large portion of the population of humanity

are in a certain sense condemned to use drugs to survive and

to cope with terrible condition of life.

Thank you, thank you very much for your insight and for your time.

Thank you, Gilberto. >> Thank you

[MUSIC]

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