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In the case of detainees, issues of human rights raise important questions about the responsibilities of the police and prison service in ensuring the welfare of suspects and prisoners, whilst also addressing criminal justice priorities, that is, detecting and preventing crime and the rehabilitation and resettlement of offenders. Articles 2, 3 and 8 of the Human Rights Act (1998)8 stipulate standards for the provision of ‘adequate, timely and appropriate medical care’ to police detainees, specifically they refer to the right to life, the right to freedom from ill-treatment and the right to physical integrity. With regards to problematic drug and alcohol users in police detention, evidence from the Police Complaints Authority in the UK suggests there are many inconsistencies in the standard of care given to this group, as well as a lack of knowledge and need for training of police officers.

In some countries, particularly in Central and Eastern Europe the most common response to drug use and drug users are repressive laws and policies as well as punitive policing. According to the Open Society Institute:

A number of countries have recently passed legislation partly inspired by the ‘zero-tolerance’ approach that dominates current U.S. drug policy. In general, official policy across the region continues to be guided by international conventions on drug use that emphasize drug interdiction and drug user incarceration approaches. Police harassment of drug users is also widespread. It is reported that, in some countries, police

round up young people suspected of drug use to search for signs of injecting or force them to be tested for HIV (Open Society Institute 2003).

This repressive approach along with human rights abuses are often exacerbated by the lack of services available for people with problematic drug and alcohol use and those that do exist reflect the punitive nature of the approach to drug use as laid down in official drug policy. Approaches such as peer-group support and counselling that attempt to address the social and psychological needs of people with problematic drug and alcohol use are rarely available, despite the evidence that such approaches are effective in reducing drug-related crime and the spread of infectious diseases.

The right to health for all citizens is covered by international human rights law although it is not always explicitly stated. The Constitution of the World Health Organization states that health relates to ‘complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 1946, no.2, 100). It emphasises this right as fundamental to all groups regardless of race, religion, political beliefs and socio-economic status, which is the responsibility of government.

The Universal Declaration of Human Rights (Article 25(1), 1948) and Article 12 of the 1966 International Covenant on Economic, Social and Cultural

Rights provides for the right of everyone to have the highest attainable standard

of physical and mental health (IFRC and RCS 2004). In addition the 1965

International Convention on the Elimination of All Forms of Racial Discrimination (Article 5(e) (iv)), the resolutions passed by the UN

Commission on Human Rights in 1999, 2001 and 2003, and the UN General Assembly Special Session on HIV/AIDS in 2001 (Declaration of Commitment) are relevant to people who inject drugs, including HIV-positive injecting drug users (IDUs) to ensure that they receive the highest attainable standard of physical and mental health. The International Federation of Red Cross (IFRC) and Red Crescent Societies (RCS), in keeping with their roles:

in protecting and promoting the health of the most vulnerable populations, IDUs as a vulnerable population merit the strong and privileged voice of social conscience. The International Federation can advocate governments to fulfil IDUs’ right to the enjoyment of the highest attainable standard of physical and mental health (IFRC and RCS 2004, 24).

The above convention provides the legal basis for ‘states to respect, protect and fulfil, equitably and in a non-discriminatory manner all IDUs’ human rights’. This includes comprehensive harm reduction programmes, along with treatment and support services (IFRC and RCS 2004, 24).

Harm reduction measures present additional options for criminal justice professionals attempting to address the problems caused by drug and alcohol use, by helping people with problematic drug use maintain their health and to continue use in a form which is not illegal. Such measures also demonstrate a

way in which the human rights of detainees can be met, in allowing them to address their drug and/or alcohol use without the pressure of criminal justice sanctions or additional punishment in prison.

In many countries, harm reduction measures, such as needle-exchange programmes and substitution treatment, are available in the community. However, due to a lack of training in harm reduction strategies, police forces can inhibit people with problematic drug or alcohol use from accessing existing services provided by governmental or non-governmental bodies. In order for measures such as needle-exchange programmes to be successful, injecting drug users need to be able to access the service without needing to register, have their names recorded by the police or be subject to harassment or arrest on the basis of possessing needles.