Thursday, March 29, 2012

UN Commission on Narcotic Drugs Unanimously Endorses Overdose Prevention

Two weeks ago in Vienna, delegates at the fifty-fifth annual meeting of the Commission on Narcotic Drugs (CND), the United Nations’ central drug policy-making body, unanimously adopted a resolution promoting measures to prevent drug overdose. Introduced by the Czech Republic and co-sponsored by Israel and Denmark (the latter on behalf of the European Union), the resolution calls on United Nations Office of Drugs and Crime (UNODC), World Health Organization (WHO), and other international organizations to work with member-states to address the global overdose epidemic.

The resolution urges countries to take action by incorporating overdose prevention into their national drug strategies.  In collaboration with WHO, UNODC will identify medical standards and gather successful examples of implementation of such efforts from experts around the world. In addition, they will provide guidance and support to countries committed to establishing overdose prevention initiatives.

At the opening of the week-long meeting the White House Office of National Drug Control Policy (ONDCP) affirmed its support for overdose prevention. In his opening statement, ONDCP Director Kerlikowske endorsed training for public health and safety personnel in recognizing overdose and administering life-saving techniques and overdose reversal medications such as naloxone.

Although CND resolutions such as this one are not legally binding on member states, they set the tone for international standards and expectations for national activities directed at addressing drug-related harms.  Being the first top-level international resolution to recognize the role of naloxone in addressing the opioid overdose epidemic, the resolution is being applauded by many public health advocates working to advance overdose prevention programming and education around the world. United Nations programs, such as UNODC and WHO are mandated to use such resolutions to set institutional strategies and priorities. 

Full text of the approved resolution is provided below. The key points for action are contained in the six points at the end of the resolution.


Promoting measures to prevent drug, in particular opioid overdose

        The Commission on Narcotic Drugs,

        Reiterating the commitments made in the Single Convention on Narcotic Drugs of 1961,[1] in the preamble to which the parties to the Convention expressed concern for the health and welfare of mankind; recognition that the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for medical purposes; and recognition that addiction to narcotic drugs constitutes a serious evil for individuals and is fraught with social and economic danger to mankind,Also recalling the Political Declaration and Plan of Action on international cooperation adopted by the General Assemblystressing the need to strengthen efforts aimed at reducing the adverse  consequences of drug abuse for individuals and society as a whole and being aware that drug overdose is one of the most dangerous of such consequences,

Taking note of the Action Plan for the Implementation of the Declaration on the Guiding Principles of Drug Demand Reduction, adopted by the General Assembly in its resolution 54/132 of 17 December 1999, which, inter alia, recognizes that demand reduction programmes should cover all areas of drug abuse prevention, ranging from  discouraging the initial use of illicit drugs to reducing the negative health and social consequences of drug abuse,

Recalling its resolution 43/3 of 15 March 2000, in which the Commission requested Member States to find strategies and increase access to and availability of services designed to reach drug users who are not integrated into or reached by existing services and are at high risk of severe health damage, drug-related infectious diseases and even fatal incidents, in order to reduce individual and public health risks,

Reaffirming that the prevention of any drug abuse is of primary importance to all Member States,

Noting that the World Drug Report 2011 highlights the high proportion of drug overdose deaths that are specifically associated with opioids,

Convinced of the need to improve the quality, coverage and variety of drug demand reduction and related drug demand reduction measures , including those targeting drugs, in particular opioid overdose prevention, as part of a continuum of health and social care,

 Understanding that opioid overdose treatment, including the provision of opioid receptor antagonists such as naloxone is a part of a comprehensive approach to services for drug users and can reverse the effects of opioids and prevent mortality,

Recognizing, that a range of factors contribute to drug overdose, including mental health problems and poly-substance use, indicating the need for a comprehensive response that includes supply reduction, information sharing, education, emergency responses and treatment,  

 Affirming that close cooperation at all levels among experts from the criminal justice, health, social and drug control sectors is critical in devising an effective and scientific evidence based response to drug, in particular opioid overdose prevention for drug users,

 Recognizing that drug, in particular opioid overdose fatalities can be substantially reduced through effective drug prevention strategies, provision of information, counselling, education, drug treatment, and related support measures, monitoring and programming,

        1.     Encourages all Member States to include effective drug, in particular opioid overdose prevention and treatment elements in national drug policies where appropriate, and to share best practices and information on drug, in particular opioid overdose prevention and  treatment, including the use of opioid receptor antagonists such as naloxone;

        2.     Requests the United Nations Office on Drugs and Crime, in collaboration with the World Health Organization, subject to the availability of extra-budgetary resources and upon the request of and in collaboration with Member States, to collect and circulate available best practices on drug, in particular opioid overdose prevention,  treatment and emergency response, including on the use and availability of opioid receptor antagonists such as naloxone and other measures based on scientific evidence,[2] ;

        3.     Also requests the United Nations Office on Drugs and Crime in collaboration with other relevant international organizations including the World Health Organizationas, as appropriate, subject to the availability of extra-budgetary resources, to provide Member States, upon request, with advice and guidance based on scientific evidence, and to provide capacity-building, on preventing mortality from drug, in particular opioid overdose;

        4.     Further requests the United Nations Office on Drugs and Crime in collaboration with other relevant international organizations including the World Health Organizationas, as appropriate, to include initiatives to prevent mortality from drug, in particular opioid overdose and related mental health issues as part of their drug demand reduction programming;

        5.     Encourages Member States, with support where requested from the United Nations Office of Drugs and Crime, to strive to ensure that all efforts are made to implement comprehensive supply and demand reduction programmes that promote the health and well-being of their citizens in accordance with national legislations;

        6. Invites Member States and other donors to consider providing extra-budgetary resources in accordance with the rules and procedures of the United Nations.

           [1]              United Nations, Treaty Series, vol. 520, No. 7515.
           [2]              Such asWorld Health Organization, Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence(Geneva, 2009).

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