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The central concern of Danish drug policy to maintain a prohibition against all non-medical and non-scientific use of narcotic drugs reflects a close adherence to the international drug control system, revealing how much this system means to Danish drug policy – more perhaps for current Danish drug policy than for the drug policy of other countries. Because whereas the Danish government has been reluctant to implement new harm-reduction measures by referring to the international drug control system, other countries like the Netherlands, Germany, Switzerland and Australia have explored the flexibility of the international drug control system to the limit. Once again, political decisions are involved here. In order to understand this, let us now take a short look at the international drug control system and its relevance as a framework for national drug policy.

The international drug control system is based on three United Nations conventions: The 1961 Single Convention on Narcotic Drugs², the 1971 Convention on Psychotropic Substances³, and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.⁴ The first two conventions established the basic control system, while the last one is primarily concerned with how control should be enforced and with international cooperation against international drug trafficking (Boister 2001; Bewley-Taylor 2003). The control system is a prohibitionist system, which requires the signatory states to limit the use of a number of substances exclusively to medical and scientific purposes, and to prohibit all other uses of these drugs. While the 1961 and 1971 conventions only required the nations to apply a criminal policy to the supply side of the illegal drug market, the 1988 convention (article 3 § 2) required the signatories also to make the possession of drugs for personal use a criminal offence under their domestic laws (Krajewski 1999; Bewley-Taylor 2003; Fazey 2003).

The control system consists of a number of lists (or schedules, as they are called) designating varying degrees of control for various drugs according to an evaluation of their addictiveness and potential for abuse (Boister 2001; Bewley-Taylor 2003). Schedule 1 consists of drugs, which are subject to the standard control mechanisms of the conventions, including drugs like heroin, cocaine and cannabis. The control mechanisms for these drugs should include: these drugs should only be produced, traded, used and possessed for medical and scientific purposes and only under licence from the state; journals should be kept for the exchange of these drugs; to pass such drugs on to individuals should require a medical prescription; and a system should be established to limit the amount of these drugs in the country. Schedule 2 contains drugs used for medical purposes, which are seen to have less potential for abuse and therefore require less control than the drugs on schedule 1. Schedule 3 consists of pharmacological products which contain only small amounts of psychoactive substances and therefore require even less control than the drugs on schedule 2. Finally, schedule 4 consists of drugs, which are deemed to be particularly dangerous. These drugs should be included in schedule 1 subject to the control mechanisms of these drugs, but they should also be subject to special control measures, which the signatories deem necessary, e.g. prohibiting any production, possession, exchange and use of these drugs unless scientific purposes are involved. Included on this list are drugs like heroine, cocaine and cannabis (Bewley-Taylor 2003). The World Health Organisation (WHO) is responsible for the medical and scientific assessment of psychoactive substances according to their addictiveness and potential for abuse, and advises the Commission on Narcotic Drugs (CND) (see below) about how drugs should be classified (Bewley-Taylor 2003). The assessment and scheduling of psychoactive drugs by the international drug control system is debated, particularly the fact that drugs like heroin and cannabis are both on the list of particularly dangerous drugs despite the differences between their addictiveness and psychoactive effects (Zimmer & Morgan 1997; Bewley-Taylor 2003). The reason for this ‘political pharmacology’ (Asmussen & Jöhncke 2004) is that the basis for scheduling is not only the pharmacological properties of the drugs, but also an assessment of their therapeutic value, as well as a political decision about what is acceptable to society (a question of morality). This means that even if it is not possible to point to particularly dangerous properties of a drug, it can still be put on schedule 4 because it lacks therapeutic value or is politically and morally unacceptable. This is why the debate about the medical use of cannabis is possible (e.g. www.medicalcannabis.com). The international drug control system thus represents a particular medico-political way of thinking about psychoactive substances. This is e.g. reflected in the fact that the Single Convention (article 49) in 1961 stated that any existing quasi-medical and non-medical use of e.g. coca and cannabis should be discontinued within 15 to 25 years.

Given the fundamental prohibitionist character of the conventions, a central question is how much room the conventions leave for countries to develop more liberal drug policies with regard to handling the non-medical use of illicit substances. This issue is central to the discussions about drug policy in Denmark, both with regard to penalisation/de-penalisation of possession of drugs for personal consumption and with regard to the more controversial treatment and harm-reduction measures like heroin maintenance treatment and safe-injection facilities. Two issues in particular are discussed in this connection: first the possibility of not enforcing or ‘soft’ enforcing drug legislation with regard to possession for personal use; and secondly the possibility of defining addiction as an illness and on this basis prescribe heroin or other drugs for treatment (Fazey 2003).

With regard to the first issue, the UN drug conventions are treaties of indirect applicability, which means that they have to be implemented into national legislation according to the constitutional principles and basic concepts of the legal system of the states concerned (Krajewski 1999; Lenton et al. 2000; Bewley-Taylor 2003). This means that even though the signatory states are required to make the possession of illicit drugs a criminal offence, they have discretion with regard to how serious an offence they want to make it, and with regard to if and how they want to enforce this legislation (Krajewski 1999; Jepsen 2001; Bewley-Taylor 2003; Fazey 2003). For instance, possession for personal consumption can be defined as a petty crime, which only requires a small fine, a warning or no sanction at all. This was at the heart of the Danish de-penalisation of possession of cannabis for personal consumption and the well-known liberal drug policy of the Netherlands. Concerning the second issue the conventions do not define ‘medical and scientific purposes’, thereby allowing states to prescribe controlled substances for medical treatment including addiction, if this is defined as an illness (Fazey 2003). In the case of the forthcoming Danish use of heroin for maintenance treatment, the only requirement is that the Minister for Health removes heroin from schedule 4. These arguments for flexibility for the signatory states are highly debated, and one of the UN drug control agencies in particular, the International Narcotics Control Board (INCB), does not agree that such ‘liberal’ measures are possible under the international drug control system.

The UN drug control conventions are administered and supervised by a number of UN bodies and agencies (Albrecht 2001; Boister 2001; Fazey 2003). The most important of these are the United Nations Commission on Narcotic Drugs (CND)⁵; the International Narcotics Control Board (INCB)⁶; and the United Nations Office on Drugs and Crime (UNODC)⁷. The CND is the policy-making body of the international drug control system. It has 53 member states elected by the Economic and Social Council of the United Nations (ECOSOC), and its main task is to analyse and discuss the world drug situation and make proposals on and implement international drug policy. The commission works on the basis of consensus, which makes it difficult to make any major changes of international drug policy, because it only takes one nation to obstruct such new measures.

The INCB is the independent monitoring body for the implementation of the UN drug conventions, and is considered to be the watchdog of the conventions because it monitors whether the parties uphold their obligations according to the conventions. The Board cannot sanction violations of the treaties, but can publish its criticism of countries which it thinks fail to do so. Furthermore, the Board administers the international system for legal trade in narcotic drugs, which involves each nation reporting each year how much of the controlled substances it expects to stock for the next year and what happened to the drugs it has stocked for the past year. The INCB has 13 members, which are elected for a five-year period. Three of the members are medical, pharmacological or pharmaceutical experts elected from a list put forward by the WHO. Ten members are elected from a list nominated by members of the UN. The INCB publishes an annual report, which includes an analysis of the world drug situation with regard to trends in use, production and trafficking, developments and changes in national drug policies, and recommendations about how nations can uphold their obligations to the conventions. Both in its annual report and on other occasions, the INCB issues statements about the drug policy of various countries if this policy goes against the prohibitionist ideology of the UN drug conventions (INCB 2001, 2002, 2003, 2004; Fazey 2003; Bewley-Taylor 2005). The INCB has thus been directly involved in the drug policy debate in various countries, for instance the Swiss debate about heroin maintenance treatment and the Danish debate about safe-injection rooms. In Denmark, during a discussion about establishing public safe-injection facilities in Copenhagen, the government consulted the INCB regarding its opinion about the legality of such a measure before passing legislation to make such a measure possible. Not surprisingly, the INCB stated that such a measure would be against the fundamental prohibition of all non-medical and non-scientific use of controlled substances under the conventions, and hence the issue was dismissed by the government and a majority of the Danish Parliament. This is perhaps the clearest example of the close connections between Danish drug policy and the international drug control system, connections which have grown closer with the changes of Danish drug policy in recent years.

The UNODC is the administrative body of international drug policy. It helps member states to adopt and implement drug control policies, and functions as a secretariat for both the INCB and the CND. The UNODC does analytical work and supervises the international drug situation, publishing The World Drug Report each year. The agency is funded mainly by contributions from the member states, with the USA as the largest contributor. This has led to criticism that because of its financial dependence on the USA the UNODC is biased against harm-reduction measures (Bewley-Taylor 2005). For instance, it has been reported that the UNODC removed references to harm reduction in its printed and electronic statements after the United States threatened to cut back funding of the office if it supported harm reduction (Bewley-Taylor 2005; Pancevski 2005; Transnational Institute 2005). However, recently UNODC has released a discussion paper on harm reduction (UNODC 2008).

A number of international non-governmental organisations (NGOs) monitor the work of the UN agencies, e.g. by publishing reports commenting on the World Drug Report by the UNODC and on what they see as the biases of this publication towards a prohibitionist line.⁸ Such NGOs also attempt to influence the development of international drug policy, particularly when international drug policy is up for discussion in the Commission on Narcotic Drugs or when the United Nations General Assembly discusses future international drug policy – as it did in 1998 and will do again in 2009. At the same time, some NGOs work to retain the status quo. The involvement of these NGOs in international drug policy shows that drug policy is not only a matter of government legislation and the activities of public authorities. In many countries including Denmark, NGOs and society as a whole play an important role in developing and carrying out drug policies, for instance by setting up needle-exchange programmes or low-threshold services for drug users. Sometimes this is done in collaboration with public authorities, and sometimes it is done autonomously. As mentioned earlier in this introduction, not only society as a whole but also the private market seem to have grown increasingly involved in drug policy in recent years. More and more players and institutions seem to be engaged in developing and carrying out drug policies.