Health Risks of Criminalisation

Having reviewed the international evidence, the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health in 2010 concluded that criminalising drug use increases the risk of illness and drug-related health problems among people who use drugs.

Higher rates of legal repression have been associated with higher HIV prevalence among people who inject drugs, without decreasing the prevalence of injecting drug use. Out of fear of arrest or punishment, individuals may adopt riskier injection practices such as sharing syringes and injection supplies, speeding up their injecting, or using drugs in unsafe places (such as shooting galleries). Hurried preparation of drugs also exposes injecting drug users to an increased risk of overdose, vascular accidents and infections, such as abscesses. The UN Special Rapporteur reported that where HIV infections occur through unsafe injecting practices, seroprevalence among injecting drug users can be as high as 50%

Police crackdowns and other interventions associated with criminalisation of drug use and possession result in the displacement of drug users from areas serviced by harm-reduction programmes, decreasing their ability to participate in needle and syringe programmes, opioid substitution therapy (OST) and to access outreach workers. Access to emergency assistance in the instance of an overdose also is impeded, and the incidence of overdose may be increased by disrupting access to regular injecting networks and drug suppliers. Those most affected by displacement often are the most marginalised; for instance, the homeless, who cannot necessarily move indoors to use drugs.

Those who use drugs may avoid seeking medical attention for fear that information regarding their drug use will be shared with authorities, which could result in arrest, imprisonment or treatment against their will. Use of drug registries may deter individuals from seeking treatment, as violations of patient confidentiality have been documented in some jurisdictions.

Some states criminalise the carrying of needles, syringes and other drug paraphernalia, contrary to the International Guidelines on HIV/AIDS and Human Rights. Fear of arrest and criminal sanctions may deter individuals from accessing needle and syringe programmes and carrying sterile equipment, which increases the likelihood of unsterile equipment use and disease transmission. Legislation penalising people carrying such equipment – including outreach workers – has been recognised as a barrier to HIV control.