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II. Obligations arising from human rights standards

1.2 Drug dependence treatment

The right to health as applied to drug policy includes access to evidence-based drug dependence treatment on a voluntary basis.

In accordance with their right to health obligations, States should:

i. Ensure the availability and accessibility of drug treatment services that are acceptable, delivered in a scientifically sound and medically appropriate manner, and of good quality (that is, with a strong evidence base and independent oversight). This means that such services should also be adequately funded; appropriate for particular vulnerable or marginalised groups; compliant with fundamental rights (such as to privacy, bodily integrity, due process, and freedom from arbitrary detention), and respectful of human dignity.

ii. Ensure that voluntary, informed consent is a precondition for any medical treatment or preventive or diagnostic intervention and that drug use or dependence alone are not grounds to deprive someone of the right to withhold consent.

iii. Ensure that non-compliance with programme rules, such as failed drug tests, do not lead to automatic involuntary discharge or temporary expulsion as a disciplinary measure.

iv. Safeguard the confidentiality of all identifying information regarding an individual’s involvement in drug-related health care to ensure that it is used solely for the purpose of advancing the health of that person.

Where compulsory drug detention centres exist, States:

v. Should take immediate measures to close such centres, release people detained in such centres, and replace such facilities with voluntary, evidence-based care and support in the community.

vi. Shall in all circumstances guard against the arbitrary detention of people who use drugs.

Commentary:

States have a legal obligation to provide drug dependence treatment to progressively realise the right to health[148] and to ensure that people who use drugs may equally benefit from scientific progress and its applications.[149] The right to health requires that States provide drug dependence treatment on a voluntary basis and that such treatment be available, accessible on a non-discriminatory basis, acceptable, and of good quality, including in prisons and other places where people are deprived of their liberty.[150] It also requires that States allocate adequate funding for the provision of drug dependence treatment.[151]

Ensuring access to drug treatment services is also critical for protecting the right to life. The Human Rights Committee has explained that the right to life ‘should not be interpreted narrowly’ and that governments ‘should take appropriate measures to address the general conditions in society that may give rise to direct threats to life or prevent individuals from enjoying their right to life with dignity’, including ‘the prevalence of life-threatening diseases, such as AIDS’.[152]

UN human rights treaty bodies and experts have repeatedly called on States to adopt and implement culturally appropriate and gender-sensitive harm reduction services, which include drug dependence treatment, including opioid agonist therapy,[153] to ensure access to these services in prison,[154] as well as to women[155] and children.[156]

The UN General Assembly Special Session 2016 Outcome Document recognises the importance of ensuring voluntary, evidence-based drug treatment and services to people who need it,[157] in accordance with standards developed by the UN Office on Drugs and Crime and the World Health Organization,[158] specifically referencing people in prison,[159] women,[160] and children.[161]

The right to health is acknowledged to include the right to ‘control one’s health and body’, the ‘right to make decisions regarding one’s health and bodily integrity’, and the right to be ‘free from interference, such as … non-consensual medical treatment and experimentation’.[162] The consequent ‘free and informed consent’ standard applies equally to drug dependence treatment and includes the right to refuse or withdraw from treatment without penalty.[163] This right must also be guaranteed in the context of alternative criminal justice measures (such as drug courts) to ensure that entry into treatment is medically indicated and not coercive and that treatment options are tailored to the needs of the individual.[164]

In some jurisdictions, ‘drug treatment courts’ or ‘drug courts’ are presented as an alternative to incarceration and are meant to offer court-supervised treatment for drug dependence for people who would otherwise go to prison for a drug-related offence. The Special Rapporteurs on the right to health and on the independence of judges and lawyers have raised concerns that the delivery of essential health care through the justice system – whereby judges and others who are not trained medical personnel make health care decisions – raises several human rights concerns, including with respect to procedural due process, informed consent, patient confidentiality and autonomy, l, and privacy.[165] In this context, they have recommended that States take cautions against the continued rollout of drug courts in countries where oversight and monitoring mechanisms are absent.[166] The Working Group on Arbitrary Detention has criticised drug courts as ‘conceptually flawed, because judges are not qualified to evaluate, monitor or supervise drug treatment’.[167] It considers that the measure of coercion involved in the ‘choice’ between imprisonment and drug treatment ‘is too great and is an unacceptable infringement on the right to choose one’s treatment freely, to refuse treatment or to discontinue it at any time’.[168] The Working Group has recommended that States discontinue the use of drug courts and ensure that no courts use the threat of imprisonment to coercively influence accused or convicted individuals into drug treatment or otherwise order forced treatment, recommending instead that matters of drug treatment be within the exclusive competence of health professionals.[169] Several members of the UN Working Group on Arbitrary Detention have similarly highlighted reservations about respect to the right to fair trial in proceedings before drug courts.[170] The Office of the UN High Commissioner for Human Rights has also raised concern that human rights violations in the drug court system are exacerbated by racial and gender biases.[171]

International law is clear that drug use or drug dependence alone are not sufficient grounds for detention.[172] Compulsory detention, even if it has a basis in law, may also constitute arbitrary detention where it is random, capricious, or disproportionate – that is, not reasonable or necessary in the circumstances of a given case.[173] Compulsory detention to control or treat people who use drugs is unsupported by scientific evidence, is considered a form of arbitrary detention, and places individuals at risk of torture and other cruel, inhuman, or degrading treatment.[174] Indeed, the Committee against Torture,[175] the Committee on the Rights of the Child,[176] the Special Rapporteur on torture,[177] the Special Rapporteur on the right to health,[178] the UN Working Group on Arbitrary Detention,[179] the International Narcotics Control Board,[180] and numerous other UN bodies[181] have raised concerns about human rights violations at compulsory detention centres in many countries throughout the world, where ‘treatment’ may consist of military-style drills, forced labour, the administration of unknown or experimental medications, State-sanctioned beatings, caning or whipping, sexual abuse, or other intentional humiliation.[182] These bodies call for the closure of such centres and the end of such practices, as well as the implementation of voluntary, evidence-based, and rights-based drug treatment services.[183] This position has been endorsed by members of the Working Group on Discrimination against Women and Girls, as well as the Special Rapporteurs on extrajudicial, summary, or arbitrary executions; on adequate housing as a component of the right to an adequate standard of living; and on the independence of judges and lawyers.[184]

The Human Rights Committee has raised concern about arbitrary arrest and detention without due process[185] as well as compulsory detoxification, forced labour, inadequate medical care, and onerous work conditions in drug detention centres.[186] It has called for a comprehensive review of relevant laws, policies, and practices vis-à-vis drug-dependent individuals to ensure alignment with the International Covenant on Civil and Political Rights and for the introduction of effective mechanisms, with formal authority, to decide on complaints brought by people deprived of their liberty in compulsory drug detention centres.[187] The Committee has also raised concern about legislation requiring compulsory labour from people with drug dependence subject to ‘involuntary isolation and medical and social rehabilitation’ and has called for a comprehensive review of such legislation and all practices involving forced labour to bring them in line with the International Covenant on Civil and Political Rights.[188]

The Committee against Torture has raised concern about the detention of people who use drugs in manual ‘labour treatment facilities’, where people are detained without access to a lawyer or appropriate medical care, has highlighted the situation of women detainees’ lack of access to medical care, including gynaecologists, and has urged that all forms of ‘treatment through labour’ be abolished.[189] The Committee has also raised concern about involuntary administrative detention in ‘transit’ and ‘rehabilitation’ centres, where people suspected of ‘drug addiction’ face arbitrary detention for prolonged periods of time without due process.[190] The Committee has called for the release of detainees, prioritising the use of community-based or alternative social services for people with drug dependence, for investigation and prosecution of allegations of illegal detention and ill-treatment, and for adequate redress for people who have been arbitrarily detained in these facilities and for their families.[191]

The UN General Assembly Special Session 2016 Outcome Document also calls on States to consider ‘practical measures to uphold the prohibition of arbitrary arrest and detention and of torture and other cruel, inhuman or degrading treatment or punishment’, encouraging instead ‘the voluntary participation of individuals with drug use disorders in treatment programmes, with informed consent’, such that ‘adequate quality of drug treatment and rehabilitation services … prevent any possible acts of cruel, inhuman or degrading treatment or punishment’.[192]

In some jurisdictions, governments have established registries identifying people who use drugs and require an individual’s entry into the registry prior to receiving treatment. This information may be available to other government entities, including law enforcement agencies.[193] The Committee on Economic, Social and Cultural Rights has raised concern about police and prosecutors gaining access to the medical records of people who use drugs who are receiving treatment in medical centres and has recommended that measures be taken to ensure the confidentiality of such records.[194] The Special Rapporteur on the right to health has raised concern that the use of drug registries deters people who use drugs from seeking treatment, out of fear that their confidential medical information may be disclosed.[195] The Special Rapporteur on torture has raised the additional concern that the use of drug registries may lead to ill-treatment by health care providers.[196] The Special Rapporteur on the right to health has also raised concern about oncologists’ routine practice of providing written reports to police about patients receiving opioid medication, in violation of the rights to privacy and confidentiality, and has recommended that excessive police interference with opioid prescription be ended.[197]

Indeed, consistent with international standards, appropriate measures to ensure confidentiality for those voluntarily undergoing drug dependence treatment include the enactment of laws and policies dictating that records of identity, diagnosis, prognosis, and treatment created or obtained in the course of treatment not be open to public inspection or disclosure, not be shared with third parties (such as employers, educational institutions, and service providers) without the informed consent of the individual concerned, and not be discoverable or admissible during legal proceedings.[198]

Relationship to the UN drug control conventions

The UN drug control conventions include a requirement to provide treatment, after-care, and rehabilitation, for people who are drug dependent, supporting this aspect of the right to health.[199] Drug dependence treatment may be provided instead of conviction or punishment where drug dependence contributed to the commission of a minor offence.[200] While compulsory drug treatment is not required by the drug conventions, they do permit States Parties to require that a person ‘shall’ undergo treatment in addition to conviction or punishment.[201] This permissive norm creates a potential tension with the human rights requirement of voluntary, informed consent to treatment.[202]

  • 148. ^

    Committee on Economic, Social and Cultural Rights, Concluding Observations: Belarus, UN Doc. E/C.12/BLR/CO/4-6 (2013), para. 15; Concluding Observations: Sweden, UN Doc. E/C.12/SWE/CO/6 (2016), paras. 41, 42; Committee on Economic, Social and Cultural Rights, Concluding Observations: Philippines, UN Doc. E/C.12/PHL/CO/5-6 (2016), para. 54; Committee on Economic, Social and Cultural Rights, Concluding Observations: Former Yugoslav Republic of Macedonia, UN Doc. E/C.12/MKD/CO/2-4 (2016), para. 52; Human Rights Council, Report of the Working Group on the Universal Periodic Review: Thailand, UN Doc. A/HRC/33/16 (2016), para. 158.157; Committee on Economic, Social and Cultural Rights, Concluding Observations: Canada, UN Doc. E/C.12/CAN/CO/6 (2016), para. 50; Committee on Economic, Social and Cultural Rights, Concluding Observations: Thailand, UN Doc. E/C.12/THA/CO/1-2 (2015), para. 32; Committee on the Elimination of Discrimination against Women, Concluding Observations: Georgia, UN Doc. CEDAW/C/GEO/CO/4-5 (2014), para. 31(e); Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover: Mission to Poland, UN Doc. A/HRC/14/20/Add.3 (2010), para. 86; Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover, UN Doc. A/65/255 (2010), para. 55.

  • 149. ^

    Committee on Economic, Social and Cultural Rights, Concluding Observations: Mauritius, UN Doc. E/C.12/MUS/CO/4 (2010), para. 27.

  • 150. ^

    Committee on Economic, Social and Cultural Rights, General Comment No. 14: The Right to Health, UN Doc. E/C.12/2000/4 (2000), para. 12.

  • 151. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Dainius Pūras, UN Doc. A/HRC/32/32 (2016), para. 100; ‘Open Letter by the Special Rapporteur on the Right of Everyone to the Highest Attainable Standard of Mental and Physical Health, Dainius Pūras, in the Context of the Preparations for the UN General Assembly Special Session on the Drug Problem (UNGASS), Which Will Take Place in New York in April 2016’, 7 December 2015, https://www.ohchr.org/sites/default/files/Documents/Issues/Health/SRLetterUNGASS7Dec2015.pdf.

  • 152. ^

    Human Rights Committee, General Comment No. 36: The Right to Life, UN Doc. CCPR/C/GC/36 (2018), paras. 3, 26.

  • 153. ^

    Committee on Economic, Social and Cultural Rights, Concluding Observations: Ecuador, UN Doc. E/C.12/ECU/CO/4 (2019), para. 48(a); Committee on Economic, Social and Cultural Rights, Concluding Observations: Estonia, UN Doc. E/C.12/EST/CO/2 (2011), para. 26 ; Committee on Economic, Social and Cultural Rights, Concluding Observations: Estonia, UN Doc. E/C.12/EST/CO/3 (2019), para. 46(a); Committee on Economic, Social and Cultural Rights, Concluding Observations: Kazakhstan, UN Doc. E/C.12/KAZ/CO/2 (2018), para. 47; Committee on Economic, Social and Cultural Rights, Concluding Observations: Lithuania, UN Doc. E/C.12/LTU/CO/2 (2014), para. 21; Committee on Economic, Social and Cultural Rights, Concluding Observations: Moldova, UN Doc. E/C.12/MDA/CO/3 (2017), para. 67; Committee on Economic, Social and Cultural Rights, Concluding Observations: Poland, UN Doc. E/C.12/POL/CO/6 (2016), para. 54; Committee on Economic, Social and Cultural Rights, Concluding Observations: Russia, UN Doc. E/C.12/RUS/CO/5 (2011), para. 29; Committee on Economic, Social and Cultural Rights, Concluding Observations: Russia, UN Doc. E/C.12/RUS/CO/6 (2017), para. 51; Committee on Economic, Social and Cultural Rights, Concluding Observations: Sweden, UN Doc. E/C.12/SWE/CO/6 (2016), para. 42; Committee on the Elimination of Discrimination against Women, Concluding Observations: Georgia, UN Doc. CEDAW/C/GEO/CO/4-5 (2014), para. 30; Committee on the Elimination of Discrimination against Women, Concluding Observations: Canada, UN Doc. CEDAW/C/CAN/CO/8-9 (2016), para. 45. On access to medication-assisted treatment in Belarus, Georgia, Indonesia, Lithuania, Russia, Ukraine, Uzbekistan, see UN Docs. E/C.12/BLR/CO/4-6 (2013); CCPR/C/GEO/CO/4 (2014); E/C.12/IDN/CO/1 (2014); E/C.12/LTU/CO/2 (2014); E/C.12/RUS/CO/5 (2011); CEDAW/C/RUS/CO/8 (2015); E/C.12/UKR/CO/6 (2014); E/C.12/UZB/CO/2 (2014).

  • 154. ^

    Committee on Economic, Social and Cultural Rights, Concluding Observations: Ecuador, UN Doc. E/C.12/ECU/CO/4 (2019), para. 48(a); Committee on Economic, Social and Cultural Rights, Concluding Observations: Kazakhstan, UN Doc. E/C.12/KAZ/CO/2 (2018), para. 47; Committee on the Elimination of Racial Discrimination, Concluding Observations: Canada, UN Doc. CERD/C/CAN/CO/21-23 (2017), para. 16(e); Committee on the Elimination of Discrimination against Women, Concluding Observations: Canada, UN Doc. CEDAW/C/CAN/CO/8-9 (2016), para. 49(c); Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover, UN Doc. A/HRC/23/41/Add.1 (2013), para. 60(g); Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Dainius Pūras, UN Doc. A/HRC/38/36 (2018), para. 23; Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Dainius Pūras, UN Doc. A/HRC/32/32 (2016), paras. 99–100; Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Report on the Follow-Up Visit to the Republic of Paraguay from 13 to 15 September 2010, UN Doc. CAT/OP/PRY/2 (2011), para. 167; Committee on Economic, Social and Cultural Rights, Concluding Observations: Poland, UN Doc. E/C.12/POL/CO/6 (2016), para. 54; Committee on Economic, Social and Cultural Rights, Concluding Observations: Sweden, UN Doc. E/C.12/SWE/CO/6 (2016), para. 42; Committee on Economic, Social and Cultural Rights, Concluding Observations: Lithuania, UN Doc. E/C.12/LTU/CO/2 (2014), para. 21; Committee on the Elimination of Discrimination against Women, Concluding Observations: Georgia, UN Doc. CEDAW/C/GEO/CO/4-5 (2014), para. 31(e); Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Manfred Nowak: Mission to Kazakhstan, UN Doc. A/HRC/13/39/Add.3 (2009), para. 85(b).

  • 155. ^

    Committee on the Elimination of Discrimination against Women, Concluding Observations: Georgia, UN Doc. CEDAW/C/GEO/CO/4-5 (2014), paras. 30, 31; Committee on the Elimination of Discrimination against Women, Concluding Observations: Canada, UN Doc. CEDAW/C/CAN/CO/8-9 (2016), paras. 44, 45; see also Committee on the Elimination of Discrimination against Women, General Recommendation No. 24: Women and Health, UN Doc. A/54/38/Rev.1, chap. I (1999), para. 2

  • 156. ^

    Committee on the Rights of the Child, General Comment No. 20: Implementation of the Rights of the Child during Adolescence, UN Doc. CRC/C/GC/20 (2016), para. 64; Committee on the Rights of the Child, Concluding Observations: Luxembourg, UN Doc. CRC/C/15/Add.92 (1998), para. 39; Committee on the Rights of the Child, Concluding Observations: Iraq, UN Doc. CRC/C/15/Add.94 (1998), para. 23; Committee on the Rights of the Child, Concluding Observations: Czech Republic, UN Doc. CRC/C/15/Add.201 (2003), para. 51; Committee on the Rights of the Child, Concluding Observations: Moldova, UN Doc. CRC/C/MDA/CO/3 (2009), para. 55(g); Committee on the Rights of the Child, Concluding Observations: Tunisia, UN Doc. CRC/C/TUN/CO/3 (2010), para. 54; Concluding Observations: Austria, UN Doc. CRC/C/AUT/CO/3-4 (2012), para. 51; Committee on the Rights of the Child, Concluding Observations: Fiji, UN Doc. CRC/C/FJI/CO/2-4 (2014), para. 52.

  • 157. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), paras. 1(i, j), 4(b, c).

  • 158. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), para. 1(p).

  • 159. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), paras. 1(i, j), 4(b, c).

  • 160. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), paras. 1(i, j), 4(b, c).

  • 161. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), para. 4(e).

  • 162. ^

    Committee on Economic, Social and Cultural Rights, General Comment No. 14: The Right to Health, UN Doc. E/C.12/2000/4 (2000), para. 8; see International Covenant on Economic, Social and Cultural Rights, G.A. Res. 2200A (XXI) (1966), art. 12; Convention on the Rights of Persons with Disabilities, G.A. Res. 61/106 (2006), art. 25(d); International Covenant on Civil and Political Rights, G.A. Res. 2200A (XXI) (1966), art. 7; Report of the Special Rapporteur on the Rights of Persons with Disabilities, UN Doc. A/73/161 (2018), paras. 9, 14–15.

  • 163. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. A/65/255 (2010), para. 32; Report of the Special Rapporteur on the Rights of Persons with Disabilities, UN Doc. A/73/161 (2018), paras. 9, 14–15.

  • 164. ^

    Report of the Working Group on Arbitrary Detention: Visit to Canada, UN Doc. E/CN.4/2006/7/Add.2 (2005), para. 57; Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), para. 83; Report of the High Commissioner for Human Rights on Implementation of the Joint Commitment to Effectively Addressing and Countering the World Drug Problem with Regard to Human Rights, UN Doc. A/HRC/39/39 (2018), paras. 53–54.

  • 165. ^

    UN Human Rights Special Procedures, ‘Drug Courts Pose Dangers of Punitive Approaches Encroaching on Medical and Health Care Matters, UN Experts Say’, 20 March 2019, https://www.unodc.org/documents/commissions/CND/2019/Contributions/UN_Entities/InfoNote20March2019.pdf.

  • 166. ^

    UN Human Rights Special Procedures, ‘Drug Courts Pose Dangers of Punitive Approaches Encroaching on Medical and Health Care Matters, UN Experts Say’, 20 March 2019, https://www.unodc.org/documents/commissions/CND/2019/Contributions/UN_Entities/InfoNote20March2019.pdf.

  • 167. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), para. 32.

  • 168. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), para. 83.

  • 169. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), paras. 32, 71, 83, 102, 126(h).

  • 170. ^

    Report of the Working Group on Arbitrary Detention: Visit to Canada, UN Doc. E/CN.4/2006/7/Add.2 (2005), para. 57; Report of the High Commissioner for Human Rights on Implementation of the Joint Commitment to Effectively Addressing and Countering the World Drug Problem with Regard to Human Rights, UN Doc. A/HRC/39/39 (2018), paras. 53–54.

  • 171. ^

    Office of the High Commissioner for Human Rights, Report of the High Commissioner for Human Rights on Implementation of the Joint Commitment to Effectively Addressing and Countering the World Drug Problem with Regard to Human Rights, UN Doc. A/HRC/39/39 (2018), para. 54.

  • 172. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), para. 122; Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/30/36 (2015), para. 60; Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), paras. 40–44; see also Report of the Working Group on Arbitrary Detention, UN Doc. E/CN.4/2004/3 (2003), paras. 74, 87; Human Rights Committee, General Comment No. 35: Liberty and Security of Person, UN Doc. CCPR/C/GC/35 (2014), para. 15; European Court of Human Rights, Witold Litwa v. Poland, Application No. 26629/95, 4 April 2000, paras. 77–80.

  • 173. ^

    Human Rights Committee, Communication No. 458/1991: Womah Mukong v. Cameroon, UN Doc. CCPR/C/51/D/458/1991 (1994), para. 9.8.

  • 174. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/30/36 (2015), para. 60; Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), paras. 40–44; see also Report of the Working Group on Arbitrary Detention, UN Doc. E/CN.4/2004/3 (2003), paras. 74, 87; Human Rights Committee, General Comment No. 35: Liberty and Security of Person, UN Doc. CCPR/C/GC/35 (2014), para. 15; see also European Court of Human Rights, Witold Litwa v. Poland, Application No. 26629/95, 4 April 2000, paras. 77–80.

  • 175. ^

    Committee against Torture, Concluding Observations: Cambodia, UN Doc. CAT/C/KHM/CO/2 (2011), para. 20; Committee against Torture, Concluding Observations: Guatemala, UN Doc. CAT/C/GTM/CO/5-6 (2013), para. 20; Committee against Torture, Concluding Observations: Guatemala, UN Doc. CAT/C/GTM/CO/7 (2018), para. 30.

  • 176. ^

    Committee on the Rights of the Child, Concluding Observations: Viet Nam, UN Doc. CRC/C/VNM/CO/3-4 (2012), paras. 43–44; Committee on the Rights of the Child, Concluding Observations: Cambodia, UN Doc. CRC/C/KHM/CO/2-3 (2011), paras. 38–39.

  • 177. ^

    Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), para. 87.

  • 178. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. A/65/255 (2010), paras. 30–39.

  • 179. ^

    Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/30/36 (2015), para. 59.

  • 180. ^

    International Narcotics Control Board, Annual Report 2017 (2018), paras. 34–35.

  • 181. ^

    International Labour Organization, Office of the UN High Commissioner for Human Rights, UN Development Programme, et al., Joint Statement on Compulsory Drug Detention and Rehabilitation Centres (2012); see also Global Commission on HIV and the Law, Risks, Rights and Health (2012), rec. 3.1.1; Global Commission on HIV and the Law, Risks, Rights and Health: Supplement (2018), p. 34, rec. 8.

  • 182. ^

    Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), para. 41; Committee on Economic, Social and Cultural Rights, Concluding Observations: Belarus, UN Doc. E/C.12/BLR/CO/4-6 (2012), para. 15; World Health Organization, Assessment of Compulsory Treatment of People Who Use Drugs in Cambodia, China, Malaysia and Viet Nam (2009).

  • 183. ^

    Committee against Torture, Concluding Observations: China, UN Doc. CAT/C/CHN/CO/5 (2016), paras. 26, 4(b, c); Committee on the Rights of the Child, Concluding Observations: Cambodia, UN Doc. CRC/C/KHM/CO/2-3 (2011), para. 39; Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health: Mission to Viet Nam, UN Doc. A/HRC/20/15/Add.2 (2012), paras. 57, 64(a, d); Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), para. 87; Report of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021), para. 126(e, f); International Narcotics Control Board, Annual Report 2017 (2018), para. 35; International Narcotics Control Board, Annual Report 2016 (2017), para. 55; United Nations, ‘Statement by the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health on the Protection of People Who Use Drugs during the COVID-19 Pandemic’, 16 April 2020, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25797; see also Committee against Torture, Concluding Observations: Cambodia, UN Doc. CAT/C/KHM/CO/2 (2011), paras. 19–20.

  • 184. ^

    United Nations, ‘Statement by the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health on the Protection of People Who Use Drugs during the COVID-19 Pandemic’, 16 April 2020, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25797.

  • 185. ^

    Human Rights Committee, Concluding Observations: Lao People’s Democratic Republic, UN Doc. CCPR/C/LAO/CO/1 (2019), para. 37.

  • 186. ^

    Human Rights Committee, Concluding Observations: Viet Nam, UN Doc. CCPR/C/VNM/CO/3 (2019), para. 31.

  • 187. ^

    Human Rights Committee, Concluding Observations: Viet Nam, UN Doc. CCPR/C/VNM/CO/3 (2019), para. 32.

  • 188. ^

    Human Rights Committee, Concluding Observations: Belarus, UN Doc. CCPR/C/BLR/CO/5 (2018), paras. 37(b), 38.

  • 189. ^

    Committee against Torture, Concluding Observations: Belarus, UN Doc. CAT/C/BLR/CO/5 (2018), paras. 23–24.

  • 190. ^

    Committee against Torture, Concluding Observations: Rwanda, UN Doc. CAT/C/RWA/CO/2 (2017), para. 30.

  • 191. ^

    Committee against Torture, Concluding Observations: Rwanda, UN Doc. CAT/C/RWA/CO/2 (2017), para. 31.

  • 192. ^

    UN General Assembly, Resolution S-30/1: Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016), paras. 1(j), 4(c), 4(o).

  • 193. ^

    Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), para. 73; Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover, UN Doc. A/65/255 (2010), para. 20; Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover, UN Doc. A/64/272 (2009), para. 89; Joint United Nations Programme on HIV/AIDS, Do No Harm: Health, Human Rights and People Who Use Drugs (2016).

  • 194. ^

    Committee on Economic, Social and Cultural Rights, Concluding Observations: Kazakhstan, UN Doc. E/C.12/KAZ/CO/2, paras. 46–47.

  • 195. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Anand Grover, UN Doc. A/65/255 (2010), para. 20; see also Global Commission on HIV and the Law, Risks, Rights and Health (2012), rec. 3.1.2.

  • 196. ^

    Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan Méndez, UN Doc. A/HRC/22/53 (2013), para. 73.

  • 197. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health on His Visit to Armenia, UN Doc. A/HRC/38/36/Add.2 (2018), paras. 105, 111(h).

  • 198. ^

    Committee on Economic, Social and Cultural Rights, General Comment No. 14: The Right to Health, UN Doc. E/C.12/2000/4 (2000), para. 12(b), n.8. In citing to the right to privacy in the International Covenant on Civil and Political Rights, the Committee on Economic, Social and Cultural Rights states that it gives ‘particular emphasis to access to information because of the special importance of this issue in relation to health’. Ibid. According to Manfred Nowak, the right to privacy includes a right of intimacy – that is, ‘to secrecy from the public of private characteristics, actions or data’. This intimacy is ensured by institutional protections but also includes generally recognised obligations of confidentiality, such as that of physicians and priests. Moreover, the ‘protection of intimacy goes beyond publication. Every invasion or even mere exploration of the intimacy sphere against the will of the person concerned may constitute unjustified interference’. M. Nowak, UN Covenant on Civil and Political Rights: CCPR Commentary (Kehl am Rein: N.P. Engel, 1993), p. 296; see also Organization for Economic Cooperation and Development, Guidelines Governing the Protection of Privacy and Transborder Flows of Personal Data (2013), paras. 9–10.

  • 199. ^

    Single Convention on Narcotic Drugs (as amended by the 1972 Protocol), 520 UNTS 7515 (1961), art. 38; Convention on Psychotropic Substances, 1019 UNTS 14956 (1971), art. 20.

  • 200. ^

    Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1582 UNTS 95 (1988), art. 3(4)(c).

  • 201. ^

    Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1582 UNTS 95 (1988), art. 3(4)(b).

  • 202. ^

    Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. A/65/255 (2010), paras. 32, 33, 37–39.

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