For information only - not an official document

5 March 2019

INCB wants more done to ensure pain relief medicine reaches all those who need it and warns of dangers of non-medical cannabis developments

In its 2018 Annual Report, the International Narcotics Control Board:

- expresses concern about legislative developments on the non-medical use of cannabis, which contravene the drug control conventions, and which pose a risk to health;

- warns of risks of poorly controlled medical cannabis programmes which may have a negative impact on public health and may increase non-medical use of cannabis;

- calls on governments to do more to ensure pain relief and other medicine is available to all those who need it, issuing a special report on the issue;

- says remarkable results have been achieved with stopping precursor chemicals being diverted to illicit drug manufacture but a new way forward is needed to deal effectively with "designer precursors" and new psychoactive substances;

- urges further support for Afghanistan; and

- condemns extrajudicial acts of violence against people suspected of drug-related activities and urges governments to address drug-related crime through formal criminal justice responses, with respect for human rights.

VIENNA, 5 March (UN Information Service) - The International Narcotics Control Board Annual Report for 2018 warns that poorly regulated medical cannabis programmes could lead to increased diversion of cannabis and cannabinoids and to increased "recreational" use of the drug.

Risks of poorly-regulated medical cannabis programmes highlighted

The report looks in detail at the risks and benefits of medical and scientific use of cannabis and cannabinoids and the impact of "recreational" use. It finds that poorly regulated medical cannabis programmes, that are not run in accordance with the drug control conventions, can result in diversion to non-medical use and adversely affect public health.

The INCB President, Viroj Sumyai, said: "Our report's focus on the use of cannabis and cannabinoids is coming at the right time, with recent legislative developments in a number of countries on medical and non-medical use. There is a great deal of misunderstanding about the safety, regulation and distribution of cannabis, particularly where recreational use has been legalized or medical cannabis programmes are expanding. There is limited knowledge of the way the international drug control system works. It has been designed by States to safeguard public health by preventing drug abuse while ensuring access to important medicines."

Changes in perception of risks of cannabis

In addition, the report says the perception of the risk of cannabis can be weakened by poorly regulated medical cannabinoids programmes. This may have contributed to the legalization of non-medical cannabis use.  The President warns that it could also reduce public concern about the dangers of cannabis use: "Legalization of cannabis for recreational purposes, as seen in a small number of countries, represents not only a challenge to the universal implementation of the treaties and the signatories to the treaties, but also a significant challenge to health and wellbeing, particularly among young people."

INCB remains committed to constructive dialogue with governments of countries where recreational use of cannabis is being permitted.

Lack of availability of pain relief and other important medicines still a major concern

The Board calls on governments to do more to end the unnecessary suffering of people who do not have access to pain relief medicines, which will contribute to achieving Sustainable Development Goal three - ensure healthy lives and promote well-being for all at all ages.

However, it also warns that the oversupply of controlled medicines, beyond the needs of patients, can pose an increased risk of diversion and abuse.

The President of INCB, Mr. Sumyai, said: "People are unnecessarily suffering pain and undergoing surgical procedures without anaesthesia, because of the lack of access to controlled medicines in some parts of the world.  In other places uncontrolled access is leading to diversion and abuse. We need to ensure more even access to these pain relief medicines."

The Board is publishing a special supplement on availability entitled "Progress on ensuring adequate access to international controlled substances for medical and scientific purposes". It looks at what is being done to ensure adequate access and how governments can be further helped to address this situation.

The supplement includes the findings of INCB's first global assessment of access to important psychotropic substances, such as those used to treat anxiety and epilepsy, which shows a growing global consumption gap. The report notes that 80 per cent of people with epilepsy live in low- and middle-income countries, where the level of consumption of essential anti-epileptic medicines under international control remains either low or unknown.

In low-income countries where the number of doctors is limited, INCB recommends that a broader range of health-care professionals, such as specially trained nurses, be allowed to prescribe controlled substances.

INCB calls for more support for Afghanistan

The drug control challenges facing Afghanistan are highlighted in the report. It notes that there have been significant increases in illicit opium production up to 2017, when the size of illicit opiate economy surpassed the value of total national licit exports.

The INCB President said the Board has been reviewing the developments in close cooperation with the Afghan Government: "If efforts to address the drug problem are not effective, poverty, insurgency and terrorism may prevail." The Board has invoked article 14 bis of the 1961 Single Convention on Narcotic Drugs, which means INCB is calling on the international community and the United Nations to urgently provide further assistance to help Afghanistan address these challenges.

Regional highlights in the report cast light on the specific drug control problems facing different parts of the world. There has been a continuing shift in policy and legislation on cannabis across North America.   In Canada, the Cannabis Act, on providing legal access to cannabis for non-medical purposes and controlling and regulating its production, distribution, sale and possession, came into force in October 2018. That same month, the Supreme Court of Mexico ruled that the prohibition of the use of cannabis for non-medical purposes was unconstitutional. Legislative changes concerning the non-medical use of cannabis occurred in various states of the United States. Meanwhile the opioid overdose epidemic has worsened in the United States, with more than 70,000 reported drug overdose deaths.

Cocaine manufacture in South America increased and appears to be impacting Europe and North America.

Fifty-one new psychoactive substances were detected for the first time on the European market in 2017. New European Union legislation will accelerate the procedures for bringing new substances under control.

Instability and armed conflicts across the Middle East have facilitated trafficking of narcotic drugs and psychoactive substances in the region.

Trafficking in and abuse of methamphetamine has reached alarming levels in East and South-East Asia, while drugs were seized in unprecedented quantities in South Asia.

INCB is concerned that several countries in Oceania are not yet parties to the international drug control conventions.

Precursors report

Looking back on 30 years of precursor control, the Precursors report notes that remarkable results have been achieved as there is virtually no diversion from international trade in those scheduled precursor chemicals to illicit channels. Nonetheless, non-scheduled chemicals "pose a significant challenge," says the President. The Board suggests that there needs to be further international policy discussions to find a way forward to address "designer" precursors and new psychoactive substances and prevent these potentially harmful substances from reaching people.

The 2018 Annual Report marks the 50th anniversary of INCB. Established by the 1961 Single Convention on Narcotic Drugs, the Board is the independent quasi-judicial body mandated by countries to monitor and support the implementation of the three international drug control conventions. The Board cooperates closely with the World Health Organization and the United Nations Office on Drugs and Crime. The conventions are rooted in the goal of safeguarding the health and welfare of humanity, including the full enjoyment of human rights.  INCB urges states to develop effective strategies for preventing drug use and providing treatment, rehabilitation and social re-integration services.

The President, Mr Sumyai, said: "Today's drug control challenges may seem daunting, but such challenges have been successfully overcome through cooperative efforts and political will. That same spirit and commitment are needed today."


INCB is the independent, quasi-judicial body charged with promoting and monitoring Government compliance with the three international drug control conventions: the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances, and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. Established by the Single Convention on Narcotic Drugs of 1961, the thirteen members of the Board are elected in a personal capacity by the Economic and Social Council for terms of five years.

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