Andrey Rylkov Foundation
for Health and Social Justice

The UN Special Rapporteur on Torture: non-provision of opioid substitution treatment is ill-treatment and torture

The UN Special Rapporteur Mr. Juan-E.-Méndez

The UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez has prepared a report focusing on forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. The report will be presented at the 22nd session of the Human Rights Council (25 February to 22 March 2013).

The report addresses issues of criminalization, lack of access to health care and essential medicines, compulsory drug treatment. The report states that criminalization and restriction of access to health care constitutes abusive treatment based on unjustified discrimination solely related to health status.

The report addresses specifically violation of the rights of people who use drugs through non-provision of opioid substitution treatment: (Paragraph 73) “A particular form of ill-treatment and possibly torture of drug users is the denial of opiate substitution treatment, including as a way of eliciting criminal confessions through inducing painful withdrawal symptoms (A/HRC/10/44 and Corr.1, para. 57). The denial of methadone treatment in custodial settings has been declared to be a violation of the right to be free from torture and ill-treatment in certain circumstances (ibid., para. 71). Similar reasoning should apply to the non-custodial context, particularly in instances where Governments impose a complete ban on substitution treatment and harm reduction measures”.

The report further states: ”By denying effective drug treatment, State drug policies intentionally subject a large group of people to severe physical pain, suffering and humiliation, effectively punishing them for using drugs and trying to coerce them into abstinence, in complete disregard of the chronic nature of dependency and of the scientific evidence pointing to the ineffectiveness of punitive measures”.

The Rapporteur notes also that ensuring the availability and accessibility of medications included in the WHO Model List of Essential Medicines is not just a reasonable step but a legal obligation under the Single Convention on Narcotic Drugs, 1961. When the failure of States to take positive steps, or to refrain from interfering with health-care services, condemns patients to unnecessary suffering from pain, States not only fall foul of the right to health but may also violate an affirmative obligation under the prohibition of torture and ill-treatment.

The report calls on the UN member states to ensure that all harm-reduction measures and drug-dependence treatment services, particularly opioid substitution therapy, are available to people who use drugs, in particular those among incarcerated populations.

The report in English is available here
Other documents for the 22nd session can be accessed here

Text by Simona Merkinaite, Advocacy and Policy Program Officer, Eurasian Harm Reduction Network (EHRN)

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