Written by Alex Betsos (they/them/theirs)
The fourth day of CND started off somewhat differently than most. Vienna, which has had nothing but gorgeous weather since I first arrived took on a different character. What had been consistent morning highs of 13 degrees dropped to a crisp 3. It was as if the weather knew what today was at the UN. Today was the day that the 58 members of the CND would decide the fate of a handful of molecules, ban them with almost no debate, and thereby require that every state that had signed the treaties must also commit to prohibiting them. This day, is one that I have affectionately come to think of as, “Scheduling Day”, and it is one of the days that I think best emphasizes the absolute futility of the UN drug system. Yet, by the afternoon, things were looking a bit warmer as many of our youth colleagues asked critical questions to various UN bodies and from the floor of the plenary itself.
“Scheduling Day”
Scheduling Day is the day at CND when a handful of molecules that we increasingly know almost nothing about come to be added to what are now incredibly long list. On the chopping block this week, were Butonitazene, 2F-DCK, 3-CMC, Dipentylone & Bromazolam, as well as a smattering of pre-precursors and pre-pre-precursors for fentanyl, MDMA, and methamphetamine.
As a nitazene (a synthetic opioid), butonitazene has been found in a handful of drug markets, which when found in opioid markets only tends to occur because of the over 100-year attempt to stop illicit opium cultivation. 2F-DCK, 2 Fluoro-DeschloroKetamine, is a ketamine analogue, probably used mostly by a handful of research chemical enthusiasts and drug nerds, is a ketamine analogue, and appeared in drug markets around the same time as DCK (although this drug has never been internationally scheduled).
3-CMC is a synthetic cathinone, which as we learned in a side event on drug checking today (more on that later) has been increasingly found in the illicit market in the Netherlands and Europe, after its chemical cousin 3-MMC was scheduled recently in the Netherlands and scheduled internationally in 2023. And lastly bromazolam is a novel benzodiazepine, which in the province of British Columbia, Canada, has been increasingly found in the fentanyl supply, after etizolam was scheduled internationally in 2020.
If you made it through reading the above (congratulations) you might have a sense of the futility of the effort. Each time we ban one drug, another appears, and although the number of totally new psychoactive substances (the UN’s language for ‘research chemical’ or ‘designer drug’) has decreased substantively over the years that doesn’t necessarily mean that old drugs can’t find a new life down the line. For instance, all fentanyl analogues were scheduled in Canada in 1997, yet that hasn’t stopped fentanyl analogues (nor fentanyl for that matter!) from appearing in the illicit drug supply in Canada since 2016. 4-MMC, more commonly known as ‘mephedrone’, which was incredibly popular in the US & UK around 2010, and was internationally scheduled in 2015, has seen a resurgence on darknet markets since the pandemic.
Could some of these substances have medical or therapeutic value? It’s possible, but we’ll likely never know, due to what sociologists Alex Stevens & Fiona Measham termed, “guilt by molecular association”. These substances are often chemically implicated by their structural similarity to other drugs that are currently within the schedules. We often lack much information about these drugs, aside from user reports online, alas they meet the fate that many of these RC drugs meet, namely, the dustbin of history, only to be replaced by newer and more obscure drugs.
Informal Dialogues
One space for potential interventions for civil societies organizations at the CND is what are called ‘Informal Dialogues’. Neither particularly informal, given that questions and answers are pre-written and pre-approved by UN bodies, nor particularly dialogic, in that one asks a question, receives an answers and then someone else asks a question, the informal dialogues provide an opportunity for civil society to receive answers to questions that they would not get a chance to ask otherwise. Several members of the Paradigma Coalition were able to ask questions this year to the World Health Organization.
Nick Kent from Students for Sensible Drug Policy Australia opened the informal asked:
How is the World Health Organisation facilitating meaningful inclusion of people who use drugs in the design and implementation of policies and strategies around existing and emerging pharmacotherapies at the global level?
In response the WHO gave a sort of broad response about how WHO guidelines of managing health conditions required the involvement of representatives from the target population, which could include either people who use drugs or youth. They noted they engage young people at the CND through the Youth Forum, as well as the Youth Council.
The WHO, however, did not mention any gaps increasingly acknowledged by the UNODC in the participatory and inclusion mechanisms of their Youth Initiative and Forum. Instead they referred to the involvement of key populations, including people who use drugs, in the development of policies in the HIV and blood-borne virus space, but did not respond specifically to the question’s focus on pharmacotherapies generally, nor anything specific on the involvement of people who use opioids in the development of international standards and approaches to opioid-assisted therapies.
After Nick, Amine Gahfez of Youth RISE, also asked the WHO what steps they were taking to advocate for member states in adopting youth-friendly harm reduction services, as well as making sure that states had naloxone easily accessible as well as drug checking services?
In response, the WHO noted that they had worked previously with our organization through Ruby [on document] and had also developed guidelines for states to remove age barriers for various harm reduction and treatment related services such as naloxone, methadone and access and sterile syringes. The WHO noted that there are limits to its capacities. While the WHO could recommend that states take action and could provide guidance on what actions they should take, they had no power to actually make states change policy.
Amine felt the answer was expected to him, he was aware they could make statements. On the other hand he was surprised that she couldn’t show more engagement, that she wasn’t very engaged, and abdicated any responsibility that the WHO could have for making better policy.
Side Events
This years CND has had more side events than ever before, particularly by Civil Society Organizations.
I attended two side events that pair nicely, and demonstrate the myriad of ways that illicit drug markets come be made knowable to either states or drug users, and the ways that those data’s sometimes come together.
Canada has been the co-sponsor of two side events on Early Warning Systems. Using a combination of drug seizure data, and more eerily drug checking data, to provide states with the ability to detect new psychoactive substances in the drug supply. As I learned yesterday, data collected by police seizures in places like Canada, the United States, and even Indonesia, are sent to the UNODC, and the WHO, which allows for the rapid scheduling of NPS on the international stage. In that way, whenever cops seize drugs at ports, or off their people, that data comes to inform not just police in Canada, but also around the world.
What was more worrisome was the way that drug checking services provided data to the state as well.
Photo that I took during the UNODC’s Side Event on Early Warning System
Drug checking data, which can be shared with state actors by researchers does not just inform knowledge in a country like Canada, but it is also shared with the UNODC and comes to inform the drug scheduling system at the international level as well.
Although I had been told that unlike the other panel on Early Warning Systems I had watched on Monday that I would be able to ask a question, I was also unable to ask a question in this side event.
In contrast, in a side event titled, “Drug Checking as a Harm Reduction Strategy to Address the Fentanyl Epidemic” several of us were able to ask questions. How nice! The panel included drug checking harm reductionists from New York City, Colombia, the Netherlands and the Colombia Minister of Justice Gloria Miranda. Coming from NYC, Yarelix Estrada talked about her experience working on the frontlines of the overdose crisis providing drug checking services.
NYC is to both Estrada’s and my knowledge one of the few harm reduction (let alone drug checking) teams that is entirely staffed by Black or Indigenous People of Colour. One key takeaway from Estrada’s presentation was that due to supply changes over the past several years it no longer makes sense to talk about opioid drug markets being contaminated with fentanyl. In an era where fentanyl is the opioid supply, drug checking and harm reduction organizations in North America need to pivot their messaging towards talking about concentration and potency.
DIMS, which has operated drug checking services in the Netherlands for decades discussed the ways that they have tried to expand their services to also examine the possibility that opioid markets in the NL are impacted by synthetic opioids such as nitazenes and fentanyl. Most of the discussion explored the ways that scheduling drugs, such as 3-MMC, and as of yesterday, 3-CMC can lead to destabilizing ‘mephedrone’ markets in Europe. Van der Grouwe noted that after the Dutch government had scheduled 3-MMC, at DIMS they increasingly saw 3-CMC replacing 3-MMC in the drug market. He cautioned that scheduling drugs such as 3-CMC can destabilize drug markets.
Estafanía Villamizar from Echele Cabeza, Acción Técnica Social, or Echele Cabeza for short, discussed how her programme had begun adopting the use of the immunoassay fentanyl test strips to check drugs in Colombia in light of fears within the community of fentanyl adulteration. While they did not find fentanyl, in other circumstances, while testing tusibi (a pink ketamine/MDMA not to be confused with the psychedelic 2C-B) they had found positive results for benzodiazepines in many of the samples. One thing that Villamizar noted was that the most valuable part of their services was not just the results, but advice from fellow youth with lived experience in terms of what to expect.
In response to the question that I asked the panel about how to communicate drug checking results to different communities, Villamizar noted the importance of youth designing drug checking materials for other youth. As youth drug policy organizers and harm reduction activists, we of course loved this answer (and we would be remiss if we didn’t note that it was 100% correct!).
Lastly, the Minister of Justice in Colombia, Gloria Miranda reasserted her government’s goal to ending the War on Drugs, while moving away from its role as the “laboratory of the US” government. She talked about how consumers and civil society were the Colombian governments #1 ally in the process of determining drug threats, and that their goal of public health. Again and again in her talk Miranda hammered in the importance of harm reduction. She noted that the Colombian state would be seeking to expand the drug checking and harm reduction services including providing financial support for currently existing workers.
Closing Note
As the CND continues, the members of Youth RISE continue to stand in solidarity with the people of Gaza, during the ongoing genocide in Palestine. We note with sadness, anger and frustration the silence of many member states, and regret that greater action is not being taken at the CND given that Israel is one of the current members. In the context of other geopolitical tensions, and human rights abuses by some member states over the past 7 years, members of the CND have been far more willing to make their disagreements publicly known in the form of walkouts or public outcries.