The WHO cocaine report the US didn't want you to see

Update 18.06.09: This blog post has resulted in mainstream media coverage of this story in the Guardian (by Ben Goldacre and George Monbiot) and an editorial in the Vancouver Sun: Suppressed report raises questions about drug policy. It also appeared on the front page of Reddit attracting 500+ comments and pulling in 60k hits in 24 hours


The largest ever study of cocaine use around the globe was carried out in the early 90's by the UN World Health Organisation (WHO) and funded by the UN Inter-regional Crime and Justice Research Institute (UNICRI), but under pressure from the US its publication was suppressed when it became clear the report's findings were in direct conflict with the myths, stereotypes and propaganda that prop up the war on drugs (read the complete leaked report here).

In March 1995 WHO/UNICRI released a briefing kit summarising the key conclusions, as a curtain raiser to the report's imminent publication.

• "Health problem; from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use.
• Few experts describe cocaine as invariably harmful to health. Cocaine-related problems are widely perceived to be more common and more severe for intensive, high-dosage users and very rare and much less severe for occasional, low-dosage users." (pg. 1)

the coca plant

In a classic example of what happens when public health pragmatism collides with criminal justice dogma, just two months later, at the 48th World Health Assembly, the US representative to the WHO threatened to withdraw US funding for WHO research projects unless they 'would dissociate itself from the conclusions of the study' (read the relevant segment here). He said;

"The United States Government had been surprised to note that the package seemed to make a case for the positive uses of cocaine, claiming that use of the coca leaf did not lead to noticeable damage to mental or physical health, that the positive health effects of coca leaf chewing might be transferable from traditional settings to other countries and cultures, and that coca production provided financial benefits to peasants...


"... it [the US] took the view that the study on cocaine, evidence of WHO's support for harm-reduction programmes and previous WHO association with organizations that supported the legalization of drugs, indicated that its programme on substance abuse was heading in the wrong direction. The press package undermined the efforts of the international community to stamp out the illegal cultivation and production of coca, inter alia through international conventions.


"The United States Government considered that, if WHO activities relating to drugs failed to reinforce proven drug control approaches, funds for the relevant programmes should be curtailed. In view of the gravity of the matter, he asked the Director-General for an assurance that WHO would dissociate itself from the conclusions of the study and that, in substance abuse activities, an approach would not be adopted that could be used to justify the continued production of coca."

It's easy to see why the US would be so opposed to the study being published as it not only challenges a number of myths and stereotypes about cocaine use, but it is highly critical of a number of US-backed policies. The report specifically highlights the criticism that supply reduction and enforcement policies are not working and that alternatives needs to be explored;

"The largest future issue is whether international organisations, such as WHO and the United Nations Drug Control Programme, and national governments will continue to focus on supply reduction approaches such as crop destruction and substitution and law enforcement efforts in the face of mounting criticism and cynicism about the effectiveness of these approaches. Countries such as Australia, Bolivia, Canada and Colombia are now interested in examining a range of options to legalize and decriminalize the personal use and possession of cocaine and other related products. There needs to be more assessment of the adverse effects of current policies and strategies and development of innovative approaches." (pg. 30)


"The studies identified strict limitations to drug control policies which rely almost exclusively on repressive measures. Current national and local approaches which over-emphasize punitive drug control measures may actually contribute to the development of heath-related problems. An increase in the adoption of more humane, compassionate responses such as education, treatment and rehabilitation programmes is seen as a desirable counterbalance to the overreliance on law enforcement measures." (pg. 29)

The study also points out that 'anti-drug' campaigns are not necessarily effective, especially mass media campaigns based on scare tactics;

"Despite a broad range of educational and prevention approaches, most programmes do not prevent myths but perpetuate stereotypes and misinform the general public. Such programmes rely on sensationalized, exaggerated statements about cocaine which misinform about patterns of use, stigmatize users, and destroy the educator's credibility. This has given most education campaigns a naïve image and has reduced confidence in the quality and accuracy of these campaigns…" (pg. 23)

With regards to who uses cocaine, the study says,

"It is not possible to describe an "average cocaine user". An enormous variety was found in the types of people who use cocaine, the amount of drug used, the frequency of use, the duration and intensity of use, the reasons for using and any associated problems they experience.’"(pg. 1)

However it does usefully establish a continuum for use, noting that the majority of harms are accrued by the minority of users at the extreme of the continuum;

• experimental use
• occasional use
• situation-specific use
• intensive use
• compulsive/dysfunctional use

Experimental and occasional use are by far the most common types of use, and compulsive/dysfunctional is far less common." (pg. 28)

The study additionally notes - in direct conflict with the accepted drug war paradigm that all use equals abuse - that:

"occasional cocaine use does not typically lead to severe or even minor physical or social problems ... a minority of people start using cocaine or related products, use casually for a short or long period, and suffer little or no negative consequences, even after years of use. ... Use of coca leaves appears to have no negative health effects and has positive, therapeutic, sacred and social functions for indigenous Andean populations."

In addressing the rise in use, the report posits that key drivers are the drug's illicit status combined with both rising wealth (for cocaine powder) and increased poverty (for crack cocaine).

"The increasing attractiveness of cocaine in the past two decades may be related to:

• the "glamour" of illicit drug use in general;
• increased wealth allowing more people access to what they believe is the most glamorous of all illicit drugs;
• widespread poverty or social disadvantage in countries such as the USA at a time when cheap coca preparations like crack have become widely available." (pg. 14)
  

The report was never officially published and according to the WHO it does not exist, however some of the project advisors are now pushing for it to be formally published. It has only emerged into the public domain because the relevant documents were leaked and found their way into the hands of the Transnational Institute drugs and democracy programme.

The suppression of this detailed, authoritative and independent report is yet more evidence of how certain governments, most conspicuously the US, have willfully refused to develop rational drug policy based on science and evidence - and worse, when evidence emerges that challenges their political prerogatives and drug war ideologies they will resort to bullying, threats and censorship to ensure it is suppressed. This is anti-science drug war posturing of the worst kind, and can only lead to poor policy development with increased social and personal costs the inevitable result.

Transform has passed this report on to the forthcoming Home Affairs Select Committee inquiry on cocaine in the hope that it might usefully be used to inform policy discussions, albeit only at the UK level for now, and some 13 years late.

Also from Transform:

• From soft drink to hard drug; a snapshot of coca, cocaine and crack, By Mike Jay
  
  
• How cocaine markets have been hit by the financial crisis
  
  
• Transform publishes comparative cost benefit analysis of prohibition vs regulation of cocaine and heroin
  
  
• Shoveling water: War on drugs - War on people (film about coca eradication)
  
  
• It is not coca growing per se that fuels the conflict in Colombia, but the fact that cocaine is illegal