Harm Reduction Strategy among Crack Cocaine Users in Bogot (Colombia) Mauricio Albarracín- Caballero
Jan 15, 2015
Harm Reduction Strategy among Crack Cocaine Users in Bogota
(Colombia) Mauricio Albarracín-Caballero
1. Background – Drug policy – Harm reduction– Human rights, health and drugs– Harm and crack cocaine – Colombia Legal Landscape on Drugs /institutional
design2. Problem 3. Strategies harm reduction in the “Bronx”
1. Local political strategy2. Judicial strategy 3. Legislative strategy
Cost/effective strategy?
Violence and drugs
Imprisonment rates in LA
Drugs: The Rebellion in Cartagena
Alternatives
• End criminalization• Model of regulation• Harm reduction strategies• Human rights • Vulnerable populations • Reducing drug market ----- Reducing the harm • Ideology ---- evidence
Harm reduction strategy
Risks/harms Evidence basedCost effectiveIncrementalAutonomy / dignity / Human Rights / participationWrong strategies
Decline in new HIV cases attributableto drug injecting in British Columbia coinciding with public health
interventions
Drug consumption in Colombia
Crack cocaine users
1,09% (in life) / 0,17 (last year) / 0,10 (last month)Use more substances / transition processSao Paulo and Bogota Very complex situations (social, economical, criminal, health, urban development, imprisonment)Profile Violence: 97% (Carvalho and Sibel, 2009)
• Mortality– External causes - 131 crack users is SP. 44% homicide
and 26% AIDS related illness (Ribeiro et at, 2006).
• Morbility – Directly: overdose and cardiovascular problems– Mental health and antisocial personality - 25% more
than cocaine users, (Kessler et al, 2012)– Sex without protection – STD and HIV. 6,6% of HIV
prevalence (Carvalho and Sibel, 2009).
Constitutional rights / Criminal law Courts / National government /
local government / police
Security issues
Problem•“Bronx” (Cartucho). •7000 problematic users in Bogota•277 homicides in the last year (90% related with drugs)•1 dose: 1 dollar (15 or 20 a day). 380-550 dollar a month. 10% users/70% of the market •Security issue: “Gancho Mosco: US 3,8 millions dollars).
Strategies
• Right to health• Social determinants of health • End criminalization • Health inequalities and space
– Knowledge production: framework of rights of the crack cocaine users (stating point)
Local political strategy: Bogota Mayor office
1. Social intervention: Economic and social rights 2. Harm reduction strategy: marihuana replacement.
Control consumption. 3. Urban planning intervention4. Economic investment
Pros: Mayor is progressive; national govermentCons: public opinion; General inspector; security
issues
Judicial strategy
• Framing the problem in constitutional rights• Use the international framework of health, soft
law and the global commission on drugs. • Accion de tutela colectiva (class action)• Unconstitutionality of the situation (estado de
cosas de inconstitucionalidad). Duty to ensure Pros: progressive rulingCons: standing issues; implementation; public
opinion; security issues
Legislative initiative
• National: End criminalization. Finish all of the procedures for minor crimes and release the crack users involved in minors crimes
• Local: regulation of the rights of drugs users.
Pros: end of the debateCons: public opinion