Ms Niamh Eastwood:

I am executive director of Release, a charity established in 1967. We are the UK centre of expertise on drugs and drug laws. I am also an associate member of the drug and alcohol research group at Middlesex University. I am a member of the expert reference group for the London commission on drugs and I am currently a technical adviser to the Global Commission on Drug Policy.

My organisation provides legal and expert drugs services to more than 1,000 people every year. We address issues such as drug-law offences, homelessness, housing insecurity, financial insecurity and problems people may be experiencing with their treatment services. It is the experiences of the people with whom we work that results in the research we publish. We publish research on the impact of the criminal law on people who use drugs and on communities that are over-policed on the basis of the drug laws. We have also done extensive research on harm-reduction interventions and harm-reduction approaches, more broadly. In 2012, we published the first global overview of models of decriminalisation adopted by jurisdictions across the world. I was a co-author on this report and have been a co-author on our subsequent updates of this publication. Therefore, we are considered experts on this topic and we have advised governments across the world on drug policy and decriminalisation. This is what I will speak about today.

As Professor Stevens has pointed out, decriminalisation is essentially the ending of criminalisation of people who use drugs. Practically, this means the removal of criminal sanctions for use and possession of drugs, with these being replaced with civil sanctions in some jurisdictions. It is worth noting that a number of jurisdictions, including Spain, Germany, Uruguay and the Netherlands, implement a no-punishment model. In 2012, when we first started to examine the global state of decriminalisation, 21 countries had taken this approach. Today, there are nearly 40 countries and dozens of states in the USA, Australia and Canada. Some of these legal frameworks are decades old. It is worth noting that the majority of countries have applied it to all controlled substances, not just cannabis.

Many governments wrongly believe that decriminalising drug possession will lead to an increase in prevalence. This is not the case. Research from the European Monitoring Centre for Drugs and Drug Addiction, EMCDDA, and leading academics, including Professor Stevens, have shown that decriminalisation is not yet linked to an increase in drug use. However, when effectively implemented and coupled with support for harm reduction and treatment, decriminalising people who use drugs can have profound and positive outcomes across health, social and economic indicators.

This is why decriminalisation is the policy position supported by the Chief Executives Board for Coordination, CEB, of the United Nations, which represents all 33 UN agencies, including the UN Office on Drugs and Crime. It is why decriminalisation has been described by UNAIDS, other UN agencies and the WHO as a critical enabler in accessing health services for key populations. It is why the 2023 report by the UN Office of the High Commissioner on Human Rights describes decriminalisation as a powerful instrument to ensure the rights of people who use drugs are protected. These positions were reflected in a more recent report by the UN special rapporteur on health.

Without decriminalising people who use drugs, we cannot attain the highest standard of health and protect fundamental rights. Portugal, which decriminalised possession of drugs in 2001, is probably the best researched of all the examples. Since then, the country has experienced significant decreases in rates of HIV transmission, a 40% reduction in injecting drug use and a 62% increase in the number of people accessing treatment. In 2021, drug-related deaths in Portugal were nine per million of the population. In the US, it was 36 times higher, at 321 per million of the population. While the high rates in North America are linked to a toxic drugs supply - something politicians and policymakers in Ireland and Europe are increasingly concerned about - the states in the US still implement a criminal justice response to deal with drug use, deterring people from accessing support. The situation in the US is so bad that there is a decline in life expectancy at a population level.

Every country in Europe that has ended criminal sanctions for drug possession has significantly lower drug-related death rates than those countries in the region that adopt a criminal justice response. These countries have the highest rates. This includes Ireland, which, as the members know, unfortunately has the highest rate of deaths among EU member states, at 92 per million of population. This is ten times higher than the rate in Portugal.

The chilling effect of criminalisation on health is persuasively reflected in a recent report by the Higher Education Policy Institute in the UK. This found that nearly one in five students did not seek emergency help because of fear of punishment when they found themselves in a scary situation with drugs. It is also reflected in opiate-related deaths in England and Wales, where 50% of people who died had not been in contact with treatment services for at least five years. There are many reasons for this but one is that when people are defined, first and foremost, as criminals, they are unlikely to come forward to seek support, be it emergency help or treatment for dependency. In our view, the policies that we currently enact through the criminal legal system are literally killing people. I am very interested in discussing with the committee some of the evidence from countries around the world.