Breaking the silence: A call to end stigma and discrimination against people affected by substance use

June 26 is the International Day Against Drug Abuse and Illicit Trafficking. On this Day, United Nations (UN) Resident Coordinator in the Philippines Gustavo Gonzalez declares, "It is the responsibility of governments, civil society organizations, healthcare professionals, and communities to stand together and challenge the prevailing stigma and discrimination. By prioritizing human rights and ensuring access to health promotion, treatment and rehabilitation, we can guarantee that every individual grappling with substance use problems receives the expected care and support. As a matter of fact good public health supports public security while preserving individual essential rights."

The full text of the op-ed, entitled "Breaking the silence: A call to end stigma and discrimination against people affected by substance use," follows.

An important group of UN experts has just released a media statement[1] on the impact of the so-called ‘war on drugs’ at global level. Supported by key evidence, the experts indicate that the ‘war on drugs’ may be understood to a significant extent as a ‘war on people’; its impact has been greatest on those who live in poverty and are frequently subject to discrimination and marginalization: the poor and most vulnerable.

As we see in many countries, addressing substance use is frequently marred by ingrained prejudices and discriminatory practices. These obstacles not only perpetuate cycles of harm but also obstruct access to critical treatment and support services for those in need. Stigma stems from misconceptions, fear, and an overall lack of understanding regarding the complex nature of substance use and substance use disorders. Society frequently views drug use as through the lens of morality rather than public health and education. Consequently, individuals grappling with substance use disorders are often subjected to judgment, rejection, and criminalization.

According to the most recent data from UNODC's World Drug Report 2023, 296 million people engaged in drug use within a single year, with over 39 million individuals suffering from drug use disorders. Numerous individuals requiring treatment find themselves unable to access it. This issue is particularly prevalent among women, who comprise nearly half of those using amphetamine-type stimulants (ATS) like “shabu”. Shockingly, only one in five women in need of ATS treatment receives the necessary care. Furthermore, in the Philippines, recent data exposes a staggering HIV prevalence rate of 29% among people who inject drugs (PWIDs) in metropolitan Cebu. These figures are exacerbated by restrictive policies that impede access to harm reduction strategies, leading to higher rates of Hepatitis C.

It is crucial that we never lose sight of the human faces hidden behind these statistics – each number represents an individual who deserves empathy, compassion, and support. Addressing stigma and discrimination requires acknowledging substance use also as a matter of human rights.

The United Nations Joint Programme for Human Rights (UNJPHR), in partnership with the Philippine government, the Commission on Human Rights and civil society actors, plays a pivotal role in championing a rights-based approach to substance use. The UNJPHR endeavors to contribute to dismantle these barriers by fostering collaboration among stakeholders, enhancing capacities, and facilitating knowledge exchange for durable solutions. By raising awareness and promoting education, we can challenge the prevailing misconceptions surrounding substance use disorders and transform public perceptions. Through advocacy for rights-based policies and evidence-backed interventions, we can ensure that no individual is left behind.

To shatter the chains of stigma and discrimination, we must prioritize people in every aspect of our endeavors. Their lived experiences offer invaluable insights into effective strategies for prevention, treatment, and support throughout the recovery journey. By empowering those affected, we can foster an inclusive and supportive environment that nurtures healing and, finally, successful reintegration.

The United Nations Joint Programme (UNJP) thrives on the invaluable input of civil society, serving as a bridge between our current drug response and the improvements necessary to extend our reach. In this context, civil society’s role is not just instrumental, but critical for a challenge requiring a whole of society approach. As I personaly noticed in my field visits across the country, civil society brings a first-hand understanding of ground realities, which is fundamental for community-driven responses.

A number of positive steps have been recently done by the Government: The Department of Justice (DoJ) has committed support for a review of the national drug law, including a public health approach for persons who use drugs, and the recognition of the health, social, education and economic factors surrounding drug activities for persons involved in low-level drug transactions.

The DoJ has also started implementing policies, including proper case build-up and dismissal of cases without strong probability of conviction, close coordination with law enforcement, and review of the Rules of Criminal Procedure to promote efficient prosecution. Steps have also been taken to address prison overcrowding, with approximately 6,000 Persons Deprived of Liberty released through the Bureau of Corrections and more than 50,000 detention prisoners released through the efforts of the Public Attorney’s Office through review of files. Meanwhile, the Department of Health (DoH) has committed to take the leadership in creating a public health approach to drugs, in collaboration with the Dangerous Drugs Board and the DoJ.

As international experience shows, addressing substance use issues and clinical disorders demands a united and comprehensive effort. It is the responsibility of governments, civil society organizations, healthcare professionals, and communities to stand together and challenge the prevailing stigma and discrimination. By prioritizing human rights and ensuring access to health promotion, treatment and rehabilitation, we can guarantee that every individual grappling with substance use problems receives the expected care and support. As a matter of fact good public health supports public security while preserving individual essential rights.

As the United Nations in the Philippines, we reaffirm our unwavering commitment to supporting the Government and all stakeholders in addressing drug-related challenges, as they are unavoidable challenges in our journey for sustainable and inclusive development.

[1] UN experts call for end to global ‘war on drugs’, OHCHR, UNSPExperts, 23 of June, 2023.