Article 38 TREATMENT OF DRUG ADDICTS

1. The Parties shall give special attention to the provision of facilities for the medical treatment, care and rehabilitation of drug addicts.
2. If a Party has a serious problem of drug addiction and its economic resources permit, it is desirable that it establish adequate facilities for the effective treatment of drug addicts.

Commentary

1. The earlier narcotics treaties did not contain any provision correspond ing to that of article 38 of the Single Convention. This does not, however, mean that the need for treatment of addicts had not been generally recognized prior to the conclusion of the Single Convention. In fact, it has already for several decades been well understood that the administrative and penal measures adopted in accordance with the terms of the narcotics treaties to keep narcotic drugs from actual and potential victims of addiction needed to be supplemented by measures of treatment, after-care and rehabilitation of addicts. I Article 38 gives express recognition in the form of a treaty provision to this long held view.

2. The terms "drug addicts" and "drug addiction" as used in paragraphs 1 and 2 cover not only the abuse of narcotic drugs which cause physical dependence-i.e. of substances which are technically "addiction producing" but also the habitual abuse of other substances subject to the Single Convention but not producing physical dependence, such as cocaine, cannabis and cannabis resin. They do not refer to the abuse of drugs outside the scope of the Single Convention. 3

3. Paragraph 1 constitutes a legal obligation, although defined in rather vague terms, while paragraph 2 is only a recommendation.

4. The Drafting Committee of the Plenipotentiary Conference explained that the term "medical treatment" referred to "necessary therapeutic treatment", and that the phrase "care and rehabilitation" was to be "understood in the broadest sense". 3 The term "treatment" as used in paragraph 2 includes what is called in paragraph 1 "medical treatment, care and rehabilitation".

5. It may sometimes be difficult to draw a dividing line between measures which may be called "care" and those which may be referred to as "rehabili tation". It is suggested that the term "care" includes such psychiatric, psychoanalytical or psychological treatment of the addict as may be necessary after he has been withdrawn from the drugs which he abused. The word "rehabilitation" covers such measures as may be required to make the addicts physically, vocationally and otherwise fit for living a normal life as useful members of society (cure of diseases, physical rehabilitation of disabled addicts, vocational training, supervision, accompanied by advice and encouragement, of a perhaps gradual transition to a normal self-reliant life, etc.).

6. The phrase "adequate facilities for the effective treatment" in the recommendation of paragraph 2 was used to leave countries free to choose whatever methods their medical authorities may consider most suitable. 4 It is also for this reason that the Plenipotentiary Conference did not accept a provision of the Third Draft 5 which would have required Parties which have a serious problem of drug addiction to "use their best endeavours to establish facilities for the compulsory treatment of drug addicts in closed institutions" if their economic resources permitted such a course of action. The Conference did not act in this way because it wished to reject the idea of the usefulness of compulsory treatment and in particular of that in closed institutions, but because it considered that the differing causes of addiction and the divergent conditions in different countries, as well as the possibility of scientific progress in understanding of the problem and in the methods of treatment of addiction, made it advisable not to lay down in the treaty a particular method of treatment as being valid under all conditions, in all countries and for the whole period of the operation of the Convention. 6 The Conference, however, adopted a resolution in which it declared that one of the most effective methods of treatment for addiction was treatment in a hospital institution having a drug-free atmosphere, and in which it urged Parties having a serious drug addiction problem and the economic means to do so, to provide such facilities. 7 The representative of the World Health Organization expressed the view that a "drug-free environment" presupposed a "closed institution". 8

7. A country which does not have sufficient economic resources for handling its various social problems does not act contrary to the recommendation of paragraph 2 if it does not establish "adequate facilities for the effective treatment of drug addicts" because it desires to use its limited means for tasks which it considers more urgent, even though it has a serious problem of addiction.

8. It may finally be suggested that it would be desirable to provide for adequate facilities for the effective treatment of addicts even in countries which in fact do not have a "serious problem of addiction". 9

1 See recommendation IX incorporated in the Final Act of the Conference of 1931 on the Suppression of Opium Smoking, urging upon Governments the importance of adequate provision being made for the treatment of opium smokers and of taking adequate steps to encourage smokers to seek the cure of their addiction and to promote, or encourage through voluntary efforts, the after-care of persons who have undergone a cure, with a view to safeguarding them against relapse; League of Nations, document C.70.M.36.1932.Xl, p. 10.

2 As regards the treatment of abusers of other drugs, see article 20 of the Convention on Psychotropic Drugs, done at Vienna on 21 February 1971; document E/CONF. 58/6. At the time of this writing this Convention has not yet come into force.

3 Records, vol. II, p. 283, foot-note 19.

4 Records, vol. 1, pp. 110 and 114.

5 Article 45, para. 2 of the Third Draft which by amendment became the recommendation of article 38, para. 2 of the Single Convention; Records, vol. II, p. 18 and vol. 1, p. 114.

6 Records, vol. I, pp. 103-114.

7 Resolution If, Records, vol. II, p. 316.

8 Records, vol. 1, p. 109. The representative of the World Health Organization also expressed the view that compulsory treatment was desirable, but that treatment need not always be provided in a closed institution.

9 The representative of New Zealand referred to "the view of the World Health Organization that all drug addiction, whatever its incidence, was always a serious problem"; Records, vol. 1, p. 107.